Tanaka H, Onodera N, Waga S
Division of Pediatrics, Iwate Prefectural Kitakami Hospital, Japan.
Tohoku J Exp Med. 1999 Mar;187(3):273-8. doi: 10.1620/tjem.187.273.
Long-term azathioprine therapy as an alternative treatment to cyclophosphamide was done in 2 children with steroid-dependent minimal-change nephrotic syndrome (MCNS). They had already been treated with prednisolone, intravenous methyl-prednisolone pulse therapy, cyclophosphamide and mizoribine. Although cyclophosphamide had been proved to be effective in maintaining their remission, the cumulative dose of the agent limited another course of cyclophosphamide therapy. Since ciclosporine therapy is much expensive, a trial of azathioprine (2 mg/kg per day) was started, and the therapy resulted in inducing sustained remission and reducing prednisolone. The patients were well tolerated the long-term azathioprine therapy over a year. Although the efficacy of azathioprine in the management of childhood MCNS might be restricted, we therefore suggest that this agent should be reconsidered as an alternative treatment to cyclophosphamide.
对2例激素依赖型微小病变肾病综合征（MCNS）患儿采用长期硫唑嘌呤治疗作为环磷酰胺的替代治疗。这2例患儿已接受过泼尼松龙、静脉注射甲泼尼龙冲击治疗、环磷酰胺和米唑立宾治疗。虽然环磷酰胺已被证明对维持其缓解有效，但该药物的累积剂量限制了再次进行环磷酰胺治疗。由于环孢素治疗费用昂贵，因此开始试用硫唑嘌呤（每日2mg/kg），该治疗导致诱导持续缓解并减少了泼尼松龙用量。患儿对长达一年的硫唑嘌呤长期治疗耐受性良好。尽管硫唑嘌呤在儿童MCNS治疗中的疗效可能有限，但我们因此建议应重新考虑将该药物作为环磷酰胺的替代治疗。
