Nickavar Azar, Safarzadeh Amir Ebrahim, Sotoudeh Kambiz, Otukesh Hasan, Hooman Nakisa
Aliasghar Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2012 Sep;6(5):346-9.
Management of frequently relapsing steroid-responsive or steroid-resistant idiopathic nephrotic syndrome (NS) in children has been a clinical challenge for pediatric nephrologists. In addition, adverse effects of long-term corticosteroids and cyclosporine administration emerge seeking a safe and effective treatment. The purpose of this study was to evaluate the safety and efficacy of mycophenolate mofetil (MMF) in these patients.
This study reviewed the outcomes of children with frequently relapsing or steroid-resistant idiopathic NS who were treated with MMF.
A total of 36 patients (23 boys and 13 girls) were included. Their mean age at the time of diagnosis of NS was 61.94 ± 43.9 months. Of the children, 91.6% of those who had frequent relapses and 8.3% of those with steroid-resistant NS responded to MMF significantly (P < .001), with no significant association between age and gender with response to MMF. The treatment was well tolerated with no significant complications.
In children with frequently relapsing NS, MMF was a safe and useful drug for maintaining remission, while it was of low value in children with steroid-resistant NS.
儿童频繁复发的类固醇反应性或类固醇抵抗性特发性肾病综合征(NS)的管理一直是儿科肾病学家面临的临床挑战。此外,长期使用皮质类固醇和环孢素会产生不良反应,因此需要寻找一种安全有效的治疗方法。本研究的目的是评估霉酚酸酯(MMF)在这些患者中的安全性和有效性。
本研究回顾了接受MMF治疗的频繁复发或类固醇抵抗性特发性NS患儿的治疗结果。
共纳入36例患者(23例男孩和13例女孩)。他们诊断为NS时的平均年龄为61.94±43.9个月。其中,频繁复发的患儿中有91.6%、类固醇抵抗性NS患儿中有8.3%对MMF有显著反应(P<.001),年龄和性别与MMF反应之间无显著关联。该治疗耐受性良好,无明显并发症。
在频繁复发的NS患儿中,MMF是一种安全有效的维持缓解药物,而在类固醇抵抗性NS患儿中价值较低。