title: Mycophenolate mofetil therapy in children with idiopathic membranous nephropathy.
abstract: BACKGROUND
  Idiopathic membranous nephropathy (IMN) is a rare form of childhood nephropathy. To date there are no standardized protocols of management for this condition in children. The aim of this study is to report on 4 children with IMN who were treated with mycophenolate mofetil (MMF).
  
  
  METHODS
  MMF was given in combination with low dose steroids and angiotensin converting enzyme antagonists in a dose of 1,200 mg/m2 body surface area in two divided doses for a minimum of 6 months.
  
  
  RESULTS
  All children had histopathological findings in keeping with Stage III membranous nephropathy. At the last hospital visit, 3 children had achieved a > 50% reduction of proteinuria with preservation of renal function. One patient who failed to respond progressed to Stage III chronic kidney disease. None of the children who were treated with MMF experienced any major side effects of the drug.
  
  
  CONCLUSIONS
  MMF, administered over a limited period, served as a safe and effective immunosuppressive agent in the treatment of this condition, in conjunction with low dose steroids and angiotensin converting enzyme inhibitors. Large multicenter randomized studies of children with IMN are necessary to assess the efficacy and long term safety of MMF.
authors.affiliation: Department of Pediatrics, Department of Anatomical Pathology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, KwaZulu-Natal, and National Health Laboratory Service, South Africa.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Bhimma
authors.forename: Elaene
authors.initials: E
authors.lastname: Naicker
authors.forename: Pratistadevi K
authors.initials: PK
authors.lastname: Ramdial
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000806:Angiotensin-Converting Enzyme Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid