Document Detail


The efficacy of an individual treatment schedule in patients with vasculitis.
MedLine Citation:
PMID:  12817059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the study was to determine the efficacy of an individual treatment schedule in patients with systemic vasculitis. Clinical, laboratory, morphological and immunological data before and after treatment were followed in 18 patients: eight with microscopic polyangiitis, two with Wegener's granulomatosis, four with leukocytoclastic vasculitis and four with necrotizing/crescentic glomerulonephritis. Patients received individual treatment for 14.89+/-13.9 months according to the disease activity. Methylprednisolone pulse therapy (PT) was given to 16 patients, mean 1.94+/-0.4 PT/patient, followed by a slowly tapered oral dose (0.7-1 mg/kg). Cyclophosphamide PT was received by 15 patients, mean 3.13+/-0.9/patient in doses of 8-10 mg/kg, followed by an oral dose of 1 mg/kg for 9.17+/-1.9 months. Four additional patients were treated with cyclosporin A for 3 months. Eleven patients received heparin for 30 days. Plasmapheresis was provided in seven patients. Two patients were treated with azathioprine and one patient with mycophenolate mofetil. There were no significant changes in serum creatinine and creatinine clearance during the observation period. Proteinuria and haematuria improved after treatment. Kidney function improved or became stable in 66.67% of patients. No patient required haemodialysis. Haematuria was no longer observed at the end of the study in nine of 11 patients. Thirteen patients (72.22%) had clinical remission. Relapses occurred in five patients. Kidney re-biopsies showed a decrease in morphological changes in 57.2%. In conclusion, individual treatment is more flexible and controls the disease activity better.
Authors:
Boriana Deliyska; Ventzislav Shurliev
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  18 Suppl 5     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-20     Completed Date:  2003-12-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  v13-5     Citation Subset:  IM    
Affiliation:
First Nephrology Clinic, Medical University, Sofia, Bulgaria. deliyska@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Antineutrophil Cytoplasmic / analysis
Antineoplastic Agents / administration & dosage*
Biopsy, Needle
Cyclosporins / administration & dosage
Disease Progression
Drug Therapy, Combination
Female
Follow-Up Studies
Glomerulonephritis / drug therapy,  pathology
Humans
Immunosuppressive Agents / administration & dosage
Kidney Function Tests
Male
Methylprednisolone / administration & dosage*
Middle Aged
Patient Care Planning*
Plasmapheresis / methods*
Risk Assessment
Sampling Studies
Severity of Illness Index
Treatment Outcome
Vasculitis / pathology*,  therapy*
Wegener Granulomatosis / drug therapy,  pathology
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Antineoplastic Agents; 0/Cyclosporins; 0/Immunosuppressive Agents; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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