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Treatment of children with Henoch-Schönlein purpura nephritis with mycophenolate mofetil.

AbstractBACKGROUND:
Henoch-Schönlein purpura (HSP) can progress to Henoch-Schönlein purpura nephritis (HSPN), and the most effective management remains unclear. Our aim was to evaluate the efficacy of mycophenolate mofetil (MMF) for treating pediatric patients with HSPN and nephrotic-range proteinuria.
METHODS:
Twelve children, seven boys and five girls, mean age 8.33 (range 6-12) years at the time of HSPN diagnosis with nephrotic-range proteinuria, were treated with MMF. All patients failed steroid treatment, and mean proteinuria at the time of MMF initiation was 5.6 g/d. MMF dosage ranged from 20 to 25 mg/kg per day. Patients also received an angiotensin-converting enzyme inhibitor (cliazapril) at MMF initiation. Mean follow-up was 3.9 (range 2.3-5.5) years.
RESULTS:
All patients responded to MMF at a mean of 2.5 (range 1-4 months). Among the 12 patients, MMF was administered for 10 months in five, 12 months in six, and 15 months in one. At last follow-up, all patients had negative proteinuria and normal renal function, and no relapses were noted. No serious adverse effects of MMF were noted in any patient.
CONCLUSION:
MMF is useful for treating pediatric patients with HSPN and nephrotic-range proteinuria.
AuthorsYue Du, Ling Hou, Chengguang Zhao, Mei Han, Yubin Wu
JournalPediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 27 Issue 5 Pg. 765-71 (May 2012) ISSN: 1432-198X [Electronic] Germany
PMID22081165 (Publication Type: Journal Article)
Chemical References
  • Angiotensin-Converting Enzyme Inhibitors
  • Immunosuppressive Agents
  • Steroids
  • Cyclophosphamide
  • Mycophenolic Acid
Topics
  • Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
  • Biopsy
  • Child
  • Cyclophosphamide (therapeutic use)
  • Drug Resistance
  • Female
  • Follow-Up Studies
  • Humans
  • IgA Vasculitis (complications, therapy)
  • Immunosuppressive Agents (therapeutic use)
  • Kidney (pathology)
  • Kidney Function Tests
  • Leukocyte Count
  • Male
  • Mycophenolic Acid (analogs & derivatives, therapeutic use)
  • Nephritis (etiology, therapy)
  • Proteinuria (etiology)
  • Retrospective Studies
  • Steroids (therapeutic use)

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