title: Effect of therapy with a new glucocorticoid, deflazacort, on linear growth and growth hormone secretion after renal transplantation.
abstract: Deflazacort is an oxazoline compound derived from prednisolone with similar antiinflammatory effects but fewer side effects. We studied changes in kidney function, growth velocity, weight/height ratio, and growth hormone secretion before and a year after substitution of deflazacort for methylprednisone in nine patients aged 9 to 15 years, 4 years after renal transplantation; all were in Tanner pubertal stage 1. Methylprednisone (mean +/- SEM: 0.2 +/- 0.02 mg/kg per day) was replaced by deflazacort (0.3 +/- 0.03 mg/kg per day) for a mean period of 15 months. Serum creatinine and calculated creatinine clearance did not change significantly during deflazacort treatment. Growth velocity increased from 1.5 +/- 0.3 to 3.2 +/- 0.5 cm/yr (p < 0.005) in the nine patients. Weight/height ratio decreased from 28.4% +/- 8.5% to 16% +/- 6.7% (p < 0.005). Cushingoid appearance decreased in all patients. Mean spontaneous growth hormone secretion increased from 2.5 +/- 0.4 to 4.4 +/- 1.2 ng/ml (p < 0.05). Our findings indicate that immunosuppressive treatment with deflazacort is as effective as methylprednisone and is associated with fewer side effects.
authors.affiliation: Departamento de Pediatría, Hospital Italiano de Buenos Aires, Argentina.
authors.forename: J R
authors.initials: JR
authors.lastname: Ferraris
authors.forename: P
authors.initials: P
authors.lastname: Fainstein Day
authors.forename: R
authors.initials: R
authors.lastname: Gutman
authors.forename: E
authors.initials: E
authors.lastname: Granillo
authors.forename: J
authors.initials: J
authors.lastname: Ramirez
authors.forename: S
authors.initials: S
authors.lastname: Ruiz
authors.forename: T
authors.initials: T
authors.lastname: Pasqualini
mesh_terms: D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000187:drug effects*; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D011282:Pregnenediones / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D011282:Pregnenediones; D013006:Growth Hormone; C021988:deflazacort; D008775:Methylprednisolone