Effects of Cyclophosphamide Pulse Therapy on the Clinical and Histopathological Findings, Particularly Crescent Formation, in a Patient with Adult-onset Steroid-refractory Henoch-Schönlein Purpura Nephritis.
A 29-year-old woman was diagnosed with Henoch-Schönlein purpura nephritis (HSPN) based on the presence of purpura and histopathological findings showing crescent formation, mesangial proliferation and IgA deposition in the glomerular mesangium. She was treated with high-dose steroids; however, the nephritic syndrome persisted. Therefore, we diagnosed her with steroid-resistant HSPN and decided to add treatment with cyclosphamide pulse therapy. After one year of treatment, the histopathological findings, including crescent formation and IgA deposition, improved, as confirmed on a renal biopsy, and the patient fulfilled the criteria for complete remission. Cyclophosphamide pulse therapy may be considered an effective treatment for intractable HSPN.
Department of Nephrology and Dialysis, Shingu Municipal Medical Center, Japan.
Yusuke
Y
Tanaka
Yuri
Y
Nakashima
Toru
T
Mima
Masaki
M
Ohya
Shuto
S
Yamamoto
Sou
S
Kobayashi
Asuka
A
Masumoto
Koji
K
Masumoto
Takurou
T
Yano
Mari
M
Moribata
Wataru
W
Yoshimoto
Shintaro
S
Yamanaka
Daisuke
D
Koreeda
Yoshiyuki
Y
Hanba
Koichi
K
Tatsuta
Toshifumi
T
Sakaguchi
Shigeo
S
Negi
Takashi
T
Shigematsu
D000328:Adult; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006339:Heart Rate; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008991:Monitoring, Physiologic; D009393:Nephritis / Q000276:immunology / Q000473:pathology*; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013256:Steroids; D003520:Cyclophosphamide