All issues > Volume 22(11); 1979

Original Article

J Korean Pediatr Soc. 1979;22(11):985-995. Published online November 15, 1979.

Methyl-prednisolone pulse Therapy in childhood Nephrotic Syndrome Resistant to Conventional Prednisolone therapy.

Whan Jong Lee, Kwang Wook Ko

¹Department of Pediatrics, College of Medicine, Seoul National University, Korea.

Abstract

Methylprednisolone pulse therapy was performed for 8 patients of childhood nephrotic syndrome who showed resistance to conventional prednisolone therapy of 4 to 8 weeks. The pathological diagnosis of the patients were: 1 case of membranous nephropathy, membrano-proliferative glomerulonephritis, Menbranoproliferative glomerulonephritis with epithelial crescent (70%), sclerosing glomerulonephritis, mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glonerulosclerosis. Creatinine clearance was above 50% of the normal in 7 cases, and less than 20% in crescentic glomerulonephritis. 20% in crescentic glomerulonephritis. 30gm/kg/D. of methylprednisolone was administered intravenously over 1~2hours, which was repeated 2 to 9 times on every other day. Thereafter, alternate day prednisolone therapy was continued. The results were as follows: Remission was attained in membranous nephropathy and MPGN, within 9 weeks and 13 weeks respectively. Marked improvement was noted in crescentic glomerulonephritis. Ccr increased from 18.5ml/min/1.73mm(2) to 59.1ml/min/1.73mm(2) 10 days later after pulse? Sclerosing glomerulonephritis showed significant improvement in clinical finding and serum albumin. There was no improvement in mesangial proliferative glomerulonephritis, focal and global glomerulonephritis, and 2 cases of focal and segmental glomerulosclerosis. These findings suggest that methylprednisolone pulse?therapy may benefit the childhood nephrotic syndrome with resistance to conventional prednisolone therapy.

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