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[Role of methylprednisolone pulse therapy of nephroses in children]
M Khiari1, A Oulebsir, L Bensalah
1Clinique médicale infantile, hôpital Mustapha, Alger, Algérie.
Insights
Methylprednisolone pulse therapy showed efficacy in some children with nephrotic syndrome, achieving remission in 37.5%. This treatment also helps identify steroid resistance in pediatric nephrology.
Area of Science:
- Pediatric Nephrology
- Pharmacology
Context:
- Steroid-dependent or resistant nephrotic syndrome in children presents a significant clinical challenge.
- Current treatment protocols often involve corticosteroids, but resistance and dependence necessitate alternative strategies.
Purpose:
- To evaluate the efficacy and safety of methylprednisolone (MP) pulse therapy in children with steroid-dependent or resistant nephrotic syndrome.
- To assess the rate of complete remission, partial remission, and steroid resistance following MP pulse therapy.
Summary:
- Sixteen children with nephrotic syndrome received methylprednisolone pulse therapy (1 g/1.73 m2 x 3) with no reported side effects.
- Complete remission was observed in 37.5% of patients within a mean of 12 days; 6% achieved partial remission.
- The majority of patients (56%) were resistant to therapy, with focal glomerulosclerosis identified in 75% of those biopsied, highlighting MP's role in confirming steroid resistance.
Impact:
- Methylprednisolone pulse therapy demonstrates potential for inducing remission in a subset of pediatric nephrotic syndrome patients.
- The study underscores the utility of methylprednisolone pulse therapy as a diagnostic tool to confirm steroid resistance in pediatric nephrotic syndrome.
- Findings contribute to understanding treatment responses and identifying underlying histopathology in difficult-to-treat nephrotic syndrome cases.
Abstract:
Methylprednisolone (MP) pulse therapy (1 g/1.73 m2 x 3) has been used without side effects in 16 children with steroid dependent or resistant nephrosis. MP allowed a complete remission in 6 patients (group I: 37.5%), after a mean duration of 12 days; 2 of them experienced early relapse; the other patients had either a too short or no follow-up. One child was on partial remission (group II: 6%). The other patients were resistant to therapy (group III: 56%); 8 of them had a renal biopsy which showed focal glomerulosclerosis in 6 (75%). The authors point out that the main interest of methylprednisolone pulse therapy is to confirm steroid resistance.