Abstract
Although cyclophosphamide is effective in the treatment of steroid-sensitive, frequently-relapsing nephrotic syndrome, little data are available on the use of this agent in the treatment of children with steroid-resistant nephrotic syndrome. Six children who had a minimal change lesion on both light and electron microscopy and who had failed to respond to an initial 8-10 week course of prednisone (2 mg/kg/d) were studied. All 6 children had a complete remission during treatment with cyclophosphamide (2 mg/kg/d for 12 weeks) and prednisone (0.5-1.0 mg/kg/d for the first 6 weeks). Three of these children have subsequently relapsed 6-18 months after treatment with cyclophosphamide, and, because of the potential gonadal toxicity of this drug, treatment was reinstituted with prednisone alone. All 3 patients sustained a complete remission within 2 weeks after restarting only steroid therapy.
These observations suggest: a) cyclophosphamide may be effective in the treatment of steroid-resistant minimal-change nephrotic syndrome; b) patients who are initially steroid resistant prior to treatment with cyclophosphamide may become steroid sensitive following such therapy; and, therefore, c) initial treatment of relapses which occur after a course of cyclophosphamide should be glucosteroids alone.
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Siegel, N., Gur, A., Krassner, L. et al. CYCLOPHOSPHAMIDE IN THE TREATMENT OF STEROID-RESISTANT MINIMAL-CHANGE NEPHROTIC SYNDROME. Pediatr Res 8, 461 (1974). https://doi.org/10.1203/00006450-197404000-00724
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DOI: https://doi.org/10.1203/00006450-197404000-00724