Bayazit A K, Noyan A, Cengiz N, Anarat A
Department of Pediatric Nephrology, School of Medicine, Cukurova University, Adana, Turkey.
Clin Nephrol. 2004 Jan;61(1):25-9. doi: 10.5414/cnp61025.
The aim of the present study is to report our clinical experiences with MMF in problematic children with chronic glomerulonephritis resistant to corticosteroids and/or other immunosuppressive drugs.
Ten patients with chronic glomerulonephritis resistant to treatment with corticosteroids and other immunosuppressive drugs were treated with mycophenolate mofetil (MMF). Causes of chronic glomerulonephritis were mesangial proliferative glomerulonephritis (4), membranoproliferative glomerulonephritis (3), chronic sclerosing glomerulonephritis (1), focal segmental glomerulosclerosis (1), diffuse endo- and extracapillary proliferative glomerulonephritis (1). MMF 15 mg/kg was used in combination with low-dose corticosteroids and angiotensin-converting enzyme inhibitors.
During 24 weeks of MMF therapy, no significant changes were detected in mean serum creatinine, albumin and proteinuria. Severe leukopenia was seen in 1 patient. Additional adverse effects, including nausea and diarrhea, were observed in another patient when the dosage was increased to 20 mg/kg per day. During MMF treatment proteinuria decreased slightly without remission in 6 of 10 patients.
Further data and clinical trials are needed to evaluate the possible role of MMF in the treatment of chronic glomerulonephritis of similar etiologies in pediatric patients.
本研究旨在报告我们使用霉酚酸酯（MMF）治疗对皮质类固醇和/或其他免疫抑制药物耐药的慢性肾小球肾炎问题儿童的临床经验。
10例对皮质类固醇和其他免疫抑制药物治疗耐药的慢性肾小球肾炎患者接受了霉酚酸酯（MMF）治疗。慢性肾小球肾炎的病因包括系膜增生性肾小球肾炎（4例）、膜增生性肾小球肾炎（3例）、慢性硬化性肾小球肾炎（1例）、局灶节段性肾小球硬化（1例）、弥漫性毛细血管内和毛细血管外增生性肾小球肾炎（1例）。MMF 15mg/kg与低剂量皮质类固醇和血管紧张素转换酶抑制剂联合使用。
在MMF治疗的24周内，平均血清肌酐、白蛋白和蛋白尿未见明显变化。1例患者出现严重白细胞减少。另1例患者在剂量增加至每日20mg/kg时出现包括恶心和腹泻在内的其他不良反应。在MMF治疗期间，10例患者中有6例蛋白尿略有下降但未缓解。
需要进一步的数据和临床试验来评估MMF在治疗儿科患者类似病因的慢性肾小球肾炎中的可能作用。
