Prompt remission of post-renal transplant nephrotic syndrome with high-dose cyclosporine.
A 2.8-year-old girl with focal segmental glomerulosclerosis had recurrence of nephrotic syndrome within 3 days of renal transplantation and the serum creatinine increased. Renal biopsy showed cellular rejection and also complete effacement of the epithelial cell foot processes. The rejection responded to methylprednisolone therapy but massive proteinuria persisted. An increase in the dose of cyclosporine A to 14 mg/kg per day was followed by immediate remission of the proteinuria. One month later, a second renal biopsy showed only focal fusion of foot processes. She remains free of proteinuria 2 years later. We propose that the higher dose of cyclosporine caused remission of the nephrotic syndrome.
Srivastava
R N
RN
Department of Pediatrics, University of Texas Medical Branch, Galveston 77555.
Kalia
A
A
Travis
L B
LB
Diven
S C
SC
Gugliuzza
K K
KK
Rajaraman
S
S
D001706:Biopsy; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008775:Methylprednisolone / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000473:pathology; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence
D016572:Cyclosporine; D003404:Creatinine; D008775:Methylprednisolone