Srivastava R N, Kalia A, Travis L B, Diven S C, Gugliuzza K K, Rajaraman S
Department of Pediatrics, University of Texas Medical Branch, Galveston 77555.
Pediatr Nephrol. 1994 Feb;8(1):94-5. doi: 10.1007/BF00868281.
A 2.8-year-old girl with focal segmental glomerulosclerosis had recurrence of nephrotic syndrome within 3 days of renal transplantation and the serum creatinine increased. Renal biopsy showed cellular rejection and also complete effacement of the epithelial cell foot processes. The rejection responded to methylprednisolone therapy but massive proteinuria persisted. An increase in the dose of cyclosporine A to 14 mg/kg per day was followed by immediate remission of the proteinuria. One month later, a second renal biopsy showed only focal fusion of foot processes. She remains free of proteinuria 2 years later. We propose that the higher dose of cyclosporine caused remission of the nephrotic syndrome.
一名2.8岁患有局灶节段性肾小球硬化的女孩在肾移植后3天内肾病综合征复发，血清肌酐升高。肾活检显示细胞性排斥反应，同时上皮细胞足突完全消失。排斥反应对甲泼尼龙治疗有反应，但大量蛋白尿持续存在。将环孢素A剂量增加至每日14mg/kg后，蛋白尿立即缓解。1个月后，第二次肾活检仅显示足突局灶融合。2年后她仍无蛋白尿。我们认为较高剂量的环孢素导致了肾病综合征的缓解。
