Effectiveness of high trough levels of cyclosporine for 5 months in a case of steroid-dependent nephrotic syndrome with severe steroid toxicity.

Abstract

Glucocorticoid treatment for steroid-dependent nephrotic syndrome (NS) is associated with severe adverse effects, such as bone fractures and epidural lipomatosis. Furthermore, a high trough level of cyclosporine (CsA) over an extended period of time is known to induce CsA nephropathy. We present a girl with steroid-dependent NS and steroid-induced vertebral compression fractures and epidural lipomatosis who was treated with a high-dose of prednisolone after experiencing several relapses. A high CsA trough level (between 147 and 225 ng/mL) over a period of only 5 months was effective in improving the vertebral compression fractures, alleviating the epidural lipomatosis by enabling the discontinuation of prednisolone treatment. Thus, high trough levels of CsA over a short period of time may enable prednisolone to be discontinued in cases of steroid-dependent NS without causing any clinical, histological, serum and/or urinary CsA-related adverse effects.

• Authors: Kenichi Kano, Yumi Yamada, Taeko Shiraiwa, Aki Shimizu, Kiyoshi Nishikura, Osamu Arisaka, Shigeki Tomita, Yoshihiko Ueda
• Journal: Nephrology (Carlton, Vic.) (Nephrology (Carlton)) Vol. 9 Issue 6 Pg. 414-7 (Dec 2004) ISSN: 1320-5358 [Print] Australia
• PMID: 15663646 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Cyclosporine
• Prednisolone

Topics

• Child, Preschool
• Cyclosporine (administration & dosage, adverse effects, pharmacokinetics)
• Female
• Glucocorticoids (adverse effects, therapeutic use)
• Humans
• Lipomatosis (chemically induced)
• Nephrotic Syndrome (drug therapy)
• Prednisolone (adverse effects, therapeutic use)
• Spinal Diseases (chemically induced)
• Spinal Fractures (chemically induced)