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Vol.62 (2016) >

Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/523

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Title: Successful therapy with tonsillectomy plus pulse therapy for the relapse of pediatric IgA nephropathy treated with multi-drugs combination therapy
Authors: Sakai, Nobuko
Kawasaki, Yukihiko
Waragai, Tomoko
Oikawa, Tomoko
Kaneko, Masatoshi
Sato, Tomoko
Suyama, Kazuhide
Hosoya, Mitsuaki
Affiliation: 小児科学講座
Source title: Fukushima Journal of Medical Science
Volume: 62
Issue: 1
Start page: 68
End page: 73
Issue Date: 2016
Abstract: Immunoglobulin A nephropathy (IgAN) is the most common form of chronic glomerulonephritis worldwide. In Japan, the treatment for use as an initial therapy was established in Guidelines for the Treatment of Childhood IgA nephropathy; however, no rescue therapy for recurrent or steroid-resistant pediatric IgAN was established. We report here a 15-year-old boy with severe IgAN, who was treated with combination therapy involving prednisolone, mizoribine, warfarin, and dilazep dihydrochloride for 2 years. The response to the combination therapy was good and both proteinuria and hematuria disappeared. The pathological findings at the second renal biopsy were improved and PSL was discontinued. However, due to nonadherence to the treatment regimen and tonsillitis, macrohematuria and an increase of proteinuria were again observed and the pathological findings at the third renal biopsy showed clear deterioration. The patient was, therefore, diagnosed with recurrent IgAN. Tonsillectomy plus methylprednisolone pulse therapy (TMP) was performed as a rescue therapy for the recurrence of severe IgAN. Both the proteinuria or hematuria subsequently disappeared, and no proteinuria or hematuria has been observed and kidney function has remained normal during a 5-year follow-up. The patient experienced no severe side effects associated with the drug regimens. In conclusion, our case suggests that TMP may be an effective and useful rescue therapy for recurrent IgAN after multi-drug combination therapy.
Publisher: The Fukushima Society of Medical Science
Publisher (Alternative foam): 福島医学会
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/523
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/523/1/FksmJMedSci_62_p68.pdf
ISSN: 0016-2590
2185-4610
DOI: 10.5387/fms.2016-3
PubMed ID: 27210310
Related Page: http://doi.org/10.5387/fms.2016-3
Rights: © 2016 The Fukushima Society of Medical Science
Appears in Collections:Vol.62 (2016)

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