2018年3月8日
Initial treatment with pulse methylprednisolone followed by short-term prednisolone and tonsillectomy for childhood IgA nephropathy
Clinical and Experimental Nephrology
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- 巻
- 22
- 号
- 5
- 開始ページ
- 1
- 終了ページ
- 7
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1007/s10157-018-1553-7
- 出版者・発行元
- Springer Tokyo
Background: Although a combination therapy, comprising 2-year high-dose oral prednisolone (PSL), is effective for treating childhood immunoglobulin A nephropathy (IgAN), severe adverse effects and residual proteinuria occur in some patients after the therapy. Methods: To clarify the efficacy of intravenous pulse methylprednisolone (IVMP
15–20 mg/kg
maximum 600 mg/day
for 3 consecutive days/week for 3 weeks) followed by short-term reduced-dose PSL (initially 1 mg/kg
maximum 30 mg on alternate days
tapered off within approximately 12 months) and tonsillectomy as an initial treatment, we retrospectively reviewed the clinical courses of 54 consecutive children with IgAN (32 boys
mean age at onset, 12.2 years
follow-up period of >
2 years) after initiating the treatment. According to the Japanese pediatric IgAN guidelines, we divided the 54 patients into the following two groups: group 1, comprising 24 patients with severe IgAN, and group 2, comprising 30 patients with mild IgAN. Results: After the treatment, proteinuria disappeared in all patients at a median of 1.6 months (group 1, 2.8 months
group 2, 0.4 months) and hematuria disappeared in 47 patients (87%) at a median of 13.2 months (group 1, 15.9 months
group 2, 13.2 months). During the follow-up period (median 5 years), no severe adverse effects were observed in any patient. At the last visit, although two patients (4%) had mild proteinuria, none developed hypertension or renal insufficiency. Conclusions: As an initial treatment, IVMP followed by short-term PSL and tonsillectomy appears to be effective for treating childhood IgAN.
15–20 mg/kg
maximum 600 mg/day
for 3 consecutive days/week for 3 weeks) followed by short-term reduced-dose PSL (initially 1 mg/kg
maximum 30 mg on alternate days
tapered off within approximately 12 months) and tonsillectomy as an initial treatment, we retrospectively reviewed the clinical courses of 54 consecutive children with IgAN (32 boys
mean age at onset, 12.2 years
follow-up period of >
2 years) after initiating the treatment. According to the Japanese pediatric IgAN guidelines, we divided the 54 patients into the following two groups: group 1, comprising 24 patients with severe IgAN, and group 2, comprising 30 patients with mild IgAN. Results: After the treatment, proteinuria disappeared in all patients at a median of 1.6 months (group 1, 2.8 months
group 2, 0.4 months) and hematuria disappeared in 47 patients (87%) at a median of 13.2 months (group 1, 15.9 months
group 2, 13.2 months). During the follow-up period (median 5 years), no severe adverse effects were observed in any patient. At the last visit, although two patients (4%) had mild proteinuria, none developed hypertension or renal insufficiency. Conclusions: As an initial treatment, IVMP followed by short-term PSL and tonsillectomy appears to be effective for treating childhood IgAN.
- リンク情報
- ID情報
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- DOI : 10.1007/s10157-018-1553-7
- ISSN : 1437-7799
- ISSN : 1342-1751
- PubMed ID : 29520517
- SCOPUS ID : 85043397974