Idiopathic membranoproliferative glomerulonephritis in Japanese children.
The course of idiopathic membranoproliferative glomerulonephritis (MPGN) in 41 Japanese children (21 boys, 20 girls) is reported. The mean follow-up period was 8 years, 9 months; 29 children with MPGN (71%) were identified by school urinary screening; 32 patients had type I MPGN, 2 type II and 7 type III; 10 patients were treated with multiple low-dose cocktail therapy (MLD), 8 with MLD followed by high-dose alternate-day (ALD) prednisolone and 21 with high-dose ALD prednisolone alone. In 1 patient, MPGN progressed to end-stage renal failure. The serum creatinine level in all of the remaining 40 patients was < or = 1.3 mg/dl at the last follow-up. Urinalysis was normal in 24 (59%). Of the 17 patients who still had urinary abnormalities, 4 had nephrotic syndrome. The incidence of remission of urinary abnormalities was highest in the patients treated with high-dose ALD prednisolone. Rebiopsy was performed in 33 patients, and revealed slight histological improvement in 11 (33%) patients, moderate improvement in 8 (24%), marked improvement in 5 (15%) and deterioration or no improvement in 9 patients (27%). Relatively few side effects of treatment were observed. The superior outcome of the MPGN patients in this compared with other studies may be the result of earlier detection and treatment.
Iitaka
K
K
Department of Paediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
Ishidate
T
T
Hojo
M
M
Kuwao
S
S
Kasai
N
N
Sakai
T
T
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003176:Complement C3; D003404:Creatinine