Methyl-prednisolone pulse Therapy in childhood Nephrotic Syndrome Resistant to Conventional Prednisolone therapy.
- Author:
Whan Jong LEE
1
;
Kwang Wook KO
Author Information
1. Department of Pediatrics, College of Medicine, Seoul National University, Korea.
- Publication Type:Original Article
- MeSH:
Creatinine;
Diagnosis;
Glomerulonephritis;
Glomerulonephritis, Membranoproliferative;
Glomerulonephritis, Membranous;
Humans;
Methylprednisolone;
Nephrotic Syndrome*;
Prednisolone*;
Serum Albumin
- From:Journal of the Korean Pediatric Society
1979;22(11):985-995
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Methylprednisolone pulse therapy was performed for 8 patients of childhood nephrotic syndrome who showed resistance to conventional prednisolone therapy of 4 to 8 weeks. The pathological diagnosis of the patients were: 1 case of membranous nephropathy, membrano-proliferative glomerulonephritis, Menbranoproliferative glomerulonephritis with epithelial crescent (70%), sclerosing glomerulonephritis, mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glonerulosclerosis. Creatinine clearance was above 50% of the normal in 7 cases, and less than 20% in crescentic glomerulonephritis. 20% in crescentic glomerulonephritis. 30gm/kg/D. of methylprednisolone was administered intravenously over 1~2hours, which was repeated 2 to 9 times on every other day. Thereafter, alternate day prednisolone therapy was continued. The results were as follows: Remission was attained in membranous nephropathy and MPGN, within 9 weeks and 13 weeks respectively. Marked improvement was noted in crescentic glomerulonephritis. Ccr increased from 18.5ml/min/1.73mm(2) to 59.1ml/min/1.73mm(2) 10 days later after pulse? Sclerosing glomerulonephritis showed significant improvement in clinical finding and serum albumin. There was no improvement in mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glomerulosclerosis. These findings suggest that methylprednisolone pulse?therapy may benefit the childhood nephrotic syndrome with resistance to conventional prednisolone therapy.
