| 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. |
| Authors | Yohei Ikezumi, Toshiaki Suzuki, Tamaki Karasawa, Hiroshi Kawachi, David J Nikolic-Paterson, Makoto Uchiyama
(Affiliation: Department of Pediatrics, Niigata University Medical and Dental Hospital, Asahimachi-Dori, Niigata, Japan. ikezumi at med.niigata-u.ac.jp)
|
| Journal | Pediatric nephrology (Berlin, Germany)
(Pediatr Nephrol)
Vol. 23
Issue 4
Pg. 645-50
(Apr 2008)
ISSN: 0931-041X Germany |
| PMID | 18038158
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Immunosuppressive Agents
- Ribonucleosides
- Prednisolone
- bredinin
- Methylprednisolone
|
| Topics |
- Adolescent
- Child
- Drug Resistance
(drug effects)
- Female
- Glomerulonephritis, IGA
(drug therapy, pathology)
- Hematuria
(drug therapy)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Kidney
(pathology)
- Macrophage Activation
(drug effects)
- Methylprednisolone
(therapeutic use)
- Prednisolone
(therapeutic use)
- Proteinuria
(drug therapy)
- Ribonucleosides
(therapeutic use)
- Treatment Outcome
|
