Madani Abbas, Isfahani Seyed-Taher, Rahimzadeh Nahid, Fereshtehnejad Seyed-Mohammad, Hoseini Rozita, Moghtaderi Mastaneh, Mohseni Parvin, Ataiee Nematollah
Division of Pediatric Nephrology, Children Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2010 Oct;4(4):292-6.
INTRODUCTION. Childhood idiopathic nephrotic syndrome is characterized by frequent relapsing courses or steroid dependency. Levamisole is a popular drug for treatment of these patients. The purpose of this study was to evaluate levamisole in children with steroid-dependent nephrotic syndrome. MATERIALS AND METHODS. We retrospectively studied 304 children with a diagnosis of steroid-dependent nephrotic syndrome or frequently relapsing nephrotic syndrome. The mean age at the time of diagnosis was 4.84 years. Following induction of complete remission with steroid therapy based on the International Study of Kidney Disease in Children's protocol and when they were taking alternative days of steroid, 2.5 mg/kg of levamisole was administered. RESULTS. The steroid dose was significantly decreased (mean reduction of 0.39 ± 0.46 g to 0.33 ± 0.38 g) after treatment with levamisole (P < .001). The number of relapses also significantly decreased (mean reduction of 0.92 ± 0.98 episodes to 1.07 ± 1.20 relapses per year; P < .001). The 14.5-month administration of levamizole had a sensitivity of 67.5% and a specificity of 71.9% to reach a dose reduction of more than 50% in steroid therapy. The duration of levamizole treatment was associated with more than 50% reduction in the number of relapses (P < .001). A 14.5-month treatment with levamizole had a sensitivity of 62.3% and a specificity of 63.6% to reach a relapse reduction of more than 50%. CONCLUSIONS. Levamisole appears to be effective in prolonging the duration of remission and decreasing the steroid dose in children with steroid-dependent nephrotic syndrome.
引言。儿童特发性肾病综合征的特点是频繁复发或依赖类固醇。左旋咪唑是治疗这些患者的常用药物。本研究的目的是评估左旋咪唑在依赖类固醇的肾病综合征患儿中的疗效。材料与方法。我们回顾性研究了304例诊断为依赖类固醇的肾病综合征或频繁复发的肾病综合征患儿。诊断时的平均年龄为4.84岁。根据儿童肾病国际研究方案，在使用类固醇疗法诱导完全缓解后，且患儿隔日服用类固醇时，给予2.5mg/kg的左旋咪唑。结果。使用左旋咪唑治疗后，类固醇剂量显著降低（平均从0.39±0.46g降至0.33±0.38g；P<.001）。复发次数也显著减少（平均从每年0.92±0.98次降至1.07±1.20次；P<.001）。14.5个月的左旋咪唑给药对类固醇疗法剂量降低超过50%的敏感性为67.5%，特异性为71.9%。左旋咪唑治疗的持续时间与复发次数减少超过50%相关（P<.001）。14.5个月的左旋咪唑治疗对复发减少超过50%的敏感性为62.3%，特异性为63.6%。结论。左旋咪唑似乎对延长依赖类固醇的肾病综合征患儿的缓解期和降低类固醇剂量有效。
