Nephrotic syndrome after conversion to alternate day steroids in two children with a history of recurrent FSGS.
FSGS is a common indication for kidney transplantation in children. However, transplantation is often complicated by recurrence of FSGS in the transplanted kidney, resulting in nephrotic syndrome and an increased risk of graft loss. Acute treatment strategies for recurrent FSGS include plasmapheresis and increased immunosuppressive therapy. There is little information on the long-term management of immunosuppression in these patients. We describe two children who were successfully treated with plasmapheresis for recurrent FSGS that occurred immediately post-transplant. Nephrotic syndrome reappeared years later when the patients were converted from daily to alternate day prednisone. In children with a history of FSGS, caution is necessary when altering the dosing schedule of prednisone.
Hanevold
Coral D
CD
Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912-3795, USA. chanevol@mail.mcg.edu
Greenbaum
Larry A
LA
D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005923:Glomerulosclerosis, Focal Segmental / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D009404:Nephrotic Syndrome / Q000209:etiology / Q000517:prevention & control; D010956:Plasmapheresis; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
D011239:Prednisolone