Bergner R, Hoffmann M, Brass H, Uppenkamp M
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen, Ludwigshafen.
Clin Nephrol. 2004 Mar;61(3):207-12. doi: 10.5414/cnp61207.
Mycophenolate mofetil is an immunosuppressive agent in transplantation which inhibits the purin neogenesis. Proliferating lymphocytes are suppressed and antibody production is decreased. Many cases of successful therapy in different kidney diseases are reported, such as diffuse proliferative lupus nephritis, pauci-immune necrotizing glomerulonephritis, focal segmental glomerular sclerosis and IgA nephropathy. We report 3 patients with IgA nephropathy who were treated with mycophenolate mofetil for more than 1 year. In all patients, proteinuria decreased significantly and the renal function remained stable. In 2 patients, kidney biopsy was repeated after 12 months and 18 months, respectively. There were no histological signs of progression of the disease. Two patients developed infections during treatment. One patient had a pneumonia, and a second patient an infection with varizella zoster. Based on our data, mycophenolate mofetil can be a potential treatment of IgA nephropathy. Further controlled studys are warranted to investigate the role of mycophenolate mofetil in IgA nephropathy.
霉酚酸酯是一种移植领域的免疫抑制剂，可抑制嘌呤的新生。增殖淋巴细胞受到抑制，抗体产生减少。有许多关于其成功治疗不同肾脏疾病的病例报道，如弥漫性增殖性狼疮性肾炎、寡免疫坏死性肾小球肾炎、局灶节段性肾小球硬化症和IgA肾病。我们报告了3例接受霉酚酸酯治疗超过1年的IgA肾病患者。所有患者的蛋白尿均显著减少，肾功能保持稳定。2例患者分别在12个月和18个月后重复进行了肾活检。没有疾病进展的组织学迹象。2例患者在治疗期间发生感染。1例患者患肺炎，另1例患者感染水痘带状疱疹。根据我们的数据，霉酚酸酯可能是IgA肾病的一种潜在治疗方法。有必要进行进一步的对照研究以探讨霉酚酸酯在IgA肾病中的作用。
