Long-term effects of levamisole treatment in childhood nephrotic syndrome
| Autor: | Ferenc Papp, Csaba Bereczki, Ibolya Haszon, Viktória Sümegi, Béla Iványi, Sándor Túri |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Nephrotic Syndrome Time Factors Adolescent Neutropenia Gastroenterology Adjuvants Immunologic Recurrence Internal medicine medicine Humans Child Retrospective Studies Proteinuria business.industry Infant Retrospective cohort study Levamisole medicine.disease Discontinuation Endocrinology Child Preschool Pediatrics Perinatology and Child Health Prednisolone Female medicine.symptom business Nephrotic syndrome medicine.drug |
| Zdroj: | Pediatric Nephrology. 19:1354-1360 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-004-1608-8 |
| Popis: | The effects of levamisole treatment on long-term outcome were evaluated in a retrospective study of frequently-relapsing (FRNS, n=15), steroid-dependent (SDNS, n=13), and steroid-resistant (SRNS, n=6) nephrotic syndrome in 34 children (21 boys, 13 girls, mean age 5.0+/-3.4 years) during a 60-month follow-up period. The definition of frequent relapses wasor = 4 relapses per year. The current relapse was treated with prednisolone 60 mg/m2 per day for 4 weeks, then with 40 mg/m2 every other day for 4 weeks, after which the dose was tapered by 10 mg weekly. From the beginning of the 5th week, levamisole was introduced at a dose of 2 mg/kg per day. The duration of levamisole treatment was 17+/-7 months. Before starting levamisole treatment the mean level of proteinuria was 2.17+/-1.34 g/day and the relapse rate was 4.41/year. By the end of levamisole therapy, proteinuria had fallen to 0.142+/-0.211 g/day and the relapse rate to 0.41/year. No relapse occurred in 23 of the 34 patients during levamisole treatment. In the 24-month follow-up period after the discontinuation of levamisole, 28 children remained in total remission, while 6 had relapses. The cumulative steroid dose before levamisole therapy was 7,564.4+/-3,497.1 mg/year and following the introduction of levamisole 1,472.9+/-1,729.9 mg/year (P0.0001). We observed reversible neutropenia in 5 patients, but no other side effects were seen. Our findings suggest that in FRNS and SDNS levamisole significantly reduces both the relapse rate and the cumulative steroid dose; therefore, it could be recommended for these patients. In SRNS patients it has also some benefit because proteinuria and the cumulative steroid dose could be reduced significantly. |
| Databáze: | OpenAIRE |
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