Immunoregulatory treatment for minimal change nephrotic syndrome

Immunological studies were performed in 18 children with minimal change nephrotic syndrome proved by biopsy examination during relapse and in 15 age matched controls. All 18 children showed dysfunction of cell mediated immunity as evidenced by low absolute lymphocyte count, low blastogenesis index in response to phytohaemagglutinin stimulation, and reduced skin sensitivity to dinitrochlorobenzene when compared with controls. All 18 patients had low serum IgG concentrations, while the IgA, IgM, and C3 concentrations in the serum were within normal limits. Based on the evidence of depressed cell mediated immunity, 14 patients with nephrotic syndrome were treated with an immunoregulatory drug l-tetramisole (levamisole) for a period of 20-24 weeks. Six patients went into complete remission within 4-20 weeks of treatment, a further six patients went into partial remission, while two did not respond. On follow up (six to 24 months after stopping levamisole), of the six patients who achieved complete remission, four continued to maintain the state and two relapsed after roughly six months. Of the six patients who achieved partial remission, two went into complete remission, two continued to be in partial remission, and two relapsed.