Neild G H, Lee H A
Postgrad Med J. 1977 Jul;53(621):382-7. doi: 10.1136/pgmj.53.621.382.
Two cases of lung granulomata associated with "crescentic" glomerulonephritis both in a clinical setting of polyarteritis nodosa were treated with high doses of intravenous methylprednisolone ("pulse therapy") in single injections of 30 mg/kg body-weight. In the first case rapidly progressive glomerulonephritis with 100% crescents was arrested and followed by improvement of renal function from a creatinine clearance of 5 ml/min to 30 ml/min; in the second case multiple lung granulomata of 8 months' standing, unresponsive to oral steroids, disappeared 8 days after treatment with high dosage intravenous methylprednisolone. The use of "pulse therapy" with methylprednisolone is advocated, not only in such cases where arteritis is known or suspected, but also in radidly progressive glomerulonephritis associated with crescents.
两例与“新月形”肾小球肾炎相关的肺肉芽肿病例,均处于结节性多动脉炎的临床背景下,接受了高剂量静脉注射甲基强的松龙(“冲击疗法”)治疗,单次注射剂量为30mg/kg体重。第一例中,伴有100%新月体的快速进行性肾小球肾炎得到控制,随后肾功能从肌酐清除率5ml/min改善至30ml/min;第二例中,持续8个月的多发肺肉芽肿,对口服类固醇无反应,在高剂量静脉注射甲基强的松龙治疗8天后消失。不仅在已知或怀疑有动脉炎的此类病例中,而且在与新月体相关的快速进行性肾小球肾炎中,都提倡使用甲基强的松龙“冲击疗法”。