Levamisole treatment in steroid sensitive nephrotic syndrome

To evaluate the effectiveness of levamisole in maintaining remission in children with steroid-sensitive nephrotic syndrome (SSNS) who had a frequent relapsing or steroid-dependent course.

All children with SSNS who had a frequent relapsing or steroid-dependent course and were treated with levamisole between 1997 and 2001 at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia were reviewed. All patients were treated by the same steroid protocol used in our unit. Levamisole was considered effective if the patient successfully remained in remission on Prednisolone 0.5 mg/kg/48 hours or less.

Nine children were treated with levamisole (3 mg/kg/48 hours) with median (range) age of 6 (3.5-10) years. Seven received levamisole for more than 6 (6-24) months and 2 were excluded because they did not adhere to treatment. Levamisole was effective in 4 patients (57%) with remarkable reduction in the number of relapses and the steroid maintenance dose. Renal biopsy was performed in 4 patients: 2 responders with biopsy findings of minimal change disease (MCD) and mesangioproliferative glomerulonephritis and another 2 non responders with biopsy findings of MCD and focal segmental glomerulosclerosis. No significant side effect was observed.

Levamisole is effective in maintaining remission in steroid SSNS in Arab children and has few side effects.