Cyclosporin A therapy for Henoch-Schönlein nephritis with nephrotic-range proteinuria

Pediatr Nephrol. 2011 Mar;26(3):411-7. doi: 10.1007/s00467-010-1723-7. Epub 2010 Dec 24.

Abstract

To evaluate the therapeutic role of cyclosporin A (CyA) for the treatment of Henoch-Schönlein nephritis (HSN), 29 patients (18 boys, 11 girls) with nephrotic-range proteinuria were analyzed retrospectively. Mean age was 8.6 years (range 2.0-15.5 years) at diagnosis of Henoch-Schönlein purpura (HSP). All patients had developed the nephrotic-range proteinuria at a mean interval of 4.4 months (range 0-50.7 months) after the diagnosis of HSP. Mean duration of CyA treatment was 12.3 months (range 2.6-55.0 months). Mean follow-up times were 3.7 years (range 1.2-12.9 years) from the beginning of the CyA treatment. Steroids were tapered off and stopped gradually after initiation of CyA. All patients responded to the CyA treatment within a mean of 1.8 months (range 1 week to 3.5 months). Twenty-three patients achieved stable remission with mean follow-up duration of 3.2 years and 6 patients seemed to become CyA-dependent, since they developed proteinuria when the treatment was stopped. Renal function was preserved in all patients but one who developed end-stage renal disease after poor compliance with CyA. We concluded that CyA treatment for HSN showing nephrotic-range proteinuria is very effective and a safe method, although some patients become CyA-dependent.

MeSH terms

  • Adolescent
  • Biopsy
  • Child
  • Child, Preschool
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use*
  • Female
  • Humans
  • IgA Vasculitis / complications
  • IgA Vasculitis / diagnosis
  • IgA Vasculitis / drug therapy*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Nephritis / diagnosis
  • Nephritis / drug therapy*
  • Nephritis / etiology
  • Nephrotic Syndrome / diagnosis
  • Nephrotic Syndrome / drug therapy*
  • Nephrotic Syndrome / etiology
  • Proteinuria / diagnosis
  • Proteinuria / drug therapy*
  • Proteinuria / etiology
  • Republic of Korea
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Cyclosporine