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Cyclosporin A therapy for severe Henoch-Schönlein nephritis with nephrotic syndrome

Authors
 Jae Il Shin  ;  Jee Min Park  ;  Youn Ho Shin  ;  Ji Hong Kim  ;  Pyung Kil Kim  ;  Jae Seung Lee  ;  Hyeon Joo Jeong 
Citation
 PEDIATRIC NEPHROLOGY, Vol.20(8) : 1093-1097, 2005 
Journal Title
PEDIATRIC NEPHROLOGY
ISSN
 0931-041X 
Issue Date
2005
MeSH
Adolescent ; Child ; Child, Preschool ; Cyclosporine/therapeutic use* ; Female ; Glomerulonephritis/drug therapy* ; Humans ; Immunosuppressive Agents/therapeutic use* ; Male ; Nephrotic Syndrome/drug therapy ; Proteinuria/drug therapy ; Purpura, Schoenlein-Henoch/complications* ; Purpura, Schoenlein-Henoch/drug therapy* ; Purpura, Schoenlein-Henoch/immunology ; Purpura, Schoenlein-Henoch/pathology ; Retrospective Studies
Keywords
Henoch-Schönlein nephritis ; Cyclosporin A ; Nephrotic syndrome ; Activity index ; Chronicity index ; Tubulointerstitial score
Abstract
To evaluate the efficacy of cyclosporin A (CyA) for treating severe Henoch-Schönlein nephritis (HSN), seven patients with nephrotic syndrome, aged 3.9–13.8 years (mean 6.5 years), were analyzed retrospectively. Mean follow-up times were 5.5 years (range 2–9 years). All underwent renal biopsy before treatment, and follow-up renal biopsy was performed in six of the seven patients. All patients improved, with 24-h protein declining from a mean of 9.2 g/m2/day (range 1.5–16 g/m2/day) to 0.3 g/m2/day (range 0.03–1.2 g/m2/day) (p=0.016) and serum albumin increasing from a mean of 2.1 g/dl (range 1.5–2.4 g/dl) to 4.6 g/dl (range 3.5–5.3 g/dl) (p=0.016) after CyA therapy. The activity index decreased significantly at the second renal biopsies obtained at a mean interval of 11.7 months after the first (6.4±3.3 vs 3.5±1.2, p=0.042, respectively), while the chronicity index and the tubulointerstitial scores did not change. On the immunofluorescent findings at the second biopsies, the degree of deposits of immunoglobulins such as IgA, IgM, C3, and fibrinogen decreased in five of the six patients. Although this case series is without controls, our study suggests that CyA may be beneficial to a subset of HSN patients with nephrotic syndrome.
Full Text
http://link.springer.com/article/10.1007%2Fs00467-005-1864-2
DOI
10.1007/s00467-005-1864-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Hong(김지홍) ORCID logo https://orcid.org/0000-0001-5352-5423
Lee, Jae Seung(이재승)
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/150506
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