Use of mizoribine as a rescue drug for steroid-resistant pediatric IgA nephropathy.
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| Abstract |
Recent clinical trials have shown a beneficial effect of mizoribine (Miz), an immunosuppressive drug, in the treatment of new-onset pediatric IgA nephropathy (IgAN). In this study, we evaluated the efficacy of Miz treatment in three children with established steroid-resistant IgAN. The patients had IgAN featuring persistent proteinuria and diffuse mesangial proliferation and had failed to respond to 2 years of treatment with prednisolone. Based upon the second biopsy results, patients were given methylprednisolone (mPSL) pulse therapy that induced a transient reduction in proteinuria, which was reversed when the mPSL dose was tapered. Miz therapy was then instigated in place of pulse mPSL. All three patients showed a substantial reduction in proteinuria and resolution of hematuria within 5 months. A follow-up biopsy in two of the patients showed a substantial reduction in the severity of glomerular lesions and a decrease in the number of activated macrophages. In conclusion, Miz therapy was found to be a safe and effective therapy in three cases of steroid-resistant pediatric IgAN. The ability of Miz to reduce the number of activated macrophages may be an important mechanism by which this drug ameliorated renal disease in these patients.
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| Authors | Yohei Ikezumi, Toshiaki Suzuki, Tamaki Karasawa, Hiroshi Kawachi, David J Nikolic-Paterson, Makoto Uchiyama |
| Journal | Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 23 Issue 4 Pg. 645-50 (Apr 2008) ISSN: 0931-041X [Print] Germany |
| PMID | 18038158 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't) |
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