All issues > Volume 30(4); 1987

Original Article

J Korean Pediatr Soc. 1987;30(4):370-377. Published online April 30, 1987.

Chlorambucil Treatment in Chidren with Frequently Relapsing Minimal Lesion Nephrotic Syndrome.

Myung Hee Chung¹, Hae Woon Chang¹, Haeng Mi Kim¹, Ja Hoo Koo¹

¹Department of Pediatrics, School of Medicine, Kyungpook University Hospital, Taegu, Korea

Abstract

A clinical study was conducted on children with frequently relapsing nephrotic syndrome to see the therapeutic effectiveness of chlorambucil therapy. Study population consisted of 21 children with biopsy-proven minimal lesion nephrotic syndrome, in whom chlorambucil therapy was given to control their frequent relapses and/or steroid dependency. Eleven patients were frequent relapser and 10 were steroid dependant. Study period extended from December 1980 to August 1985, and children whose follow-up period was less than 1 year were excluded from this study. The following results were obtained: Sex distribution showed male preponderance with male to female ratio of 4.2: 1. Remission rate after chlorambucil therapy was 66.7% at 6 months and 52.4% at 12 months. Comparison of the remission rate lasting longer than 12 months and other various parameters which could be related to the remission rate, such as age at onset of illness, duration of illness before chlorambucil treatment, selectivity index of proteinuria and presence of hematuria, showed no statistically significant differences. However, remission lasting longer than 6 months and 12 months showed statistically significant correlation with patient's age at the time of chlorambucil therapy. Patients with age over 6 years at the time of chlorambucil therapy showed longer lasting remission compared to patients under 6 years (P<0.05). Side effects of chlorambucil therapy included 12 cases of transient leukopenia in which the lowest level was 2,200/mm3, and few cases of nausea, vomiting, abdominal pain and impetigo.

Keywords :Frequently relapsing nephrotic syndrome; Steroid dependant nephrotic syndrome; Chlorambucil treatment.