Treatment of steroid-resistant post-transplant nephrotic syndrome with cyclophosphamide in a child with congenital nephrotic syndrome.
A child with congenital nephrotic syndrome underwent renal transplantation, was treated for acute rejection, and then developed nephrotic syndrome and renal failure. He was felt to have minimal change disease on allograft biopsy, but failed to respond to therapy with corticosteroids. Cyclophosphamide was substituted for cyclosporine and rapidly induced a complete remission of his nephrotic syndrome. We feel that this case not only represents an important example of a useful therapeutic approach to the child with congenital nephrotic syndrome who develops nephrotic syndrome post transplantation, and also raises questions concerning the pathogenesis of congenital nephrotic syndrome.
Flynn
J T
JT
Department of Pediatrics, St. Christopher's Hospital for Children, Temple University School of Medicine, Philadelphia, Pennsylvania 19134-1095.
Schulman
S L
SL
deChadarevian
J P
JP
Dunn
S P
SP
Kaiser
B A
BA
Polinsky
M S
MS
Baluarte
H J
HJ
D003520:Cyclophosphamide / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use; D004351:Drug Resistance; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D009404:Nephrotic Syndrome / Q000151:congenital / Q000188:drug therapy* / Q000209:etiology; D011183:Postoperative Complications
D016572:Cyclosporine; D003520:Cyclophosphamide; D008775:Methylprednisolone