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Vol.62 (2016) >

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タイトル: Successful therapy with tonsillectomy plus pulse therapy for the relapse of pediatric IgA nephropathy treated with multi-drugs combination therapy
著者: Sakai, Nobuko
Kawasaki, Yukihiko
Waragai, Tomoko
Oikawa, Tomoko
Kaneko, Masatoshi
Sato, Tomoko
Suyama, Kazuhide
Hosoya, Mitsuaki
学内所属: 小児科学講座
誌名/書名: Fukushima Journal of Medical Science
巻: 62
号: 1
開始ページ: 68
終了ページ: 73
発行日: 2016年
抄録: 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.
出版者: The Fukushima Society of Medical Science
出版者(異表記): 福島医学会
本文の言語: eng
このページのURI: http://ir.fmu.ac.jp/dspace/handle/123456789/523
本文URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/523/1/FksmJMedSci_62_p68.pdf
ISSN: 0016-2590
DOI: 10.5387/fms.2016-3
PubMed番号: 27210310
関連ページ: http://doi.org/10.5387/fms.2016-3
権利情報: © 2016 The Fukushima Society of Medical Science
出現コレクション:Vol.62 (2016)


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FksmJMedSci_62_p68.pdf522.66 kBAdobe PDFダウンロード



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