title: Long-term follow up of pediatric immunoglobulin A nephropathy treated with tonsillectomy plus methylprednisolone pulse therapy.
abstract: BACKGROUND
  The aim of this study was to clarify the long-term efficacy of tonsillectomy plus methylprednisolone pulse therapy (tonsillectomy pulse therapy [TMP]) for pediatric immunoglobulin A nephropathy (IgAN). The clinical and laboratory findings as well as the prognosis for IgAN treated with TMP at long-term follow up were evaluated.
  
  
  METHODS
  We collected data on 33 IgAN children treated with TMP. The children were retrospectively divided into two groups. Group 1 consisted of 18 children treated with TMP as the initial therapy, and group 2 consisted of 15 children treated with TMP as rescue therapy for IgAN relapse. The clinical features, and laboratory and pathological findings, including those at first and second renal biopsy as well as at the latest follow up, were analyzed for both groups.
  
  
  RESULTS
  Mean urinary protein excretion, incidence of hematuria, and serum creatinine in groups 1 and 2 were all decreased significantly after TMP compared with beforehand. The percentage of glomeruli showing crescents after TMP in groups 1 and 2 was significantly lower than before TMP. At the most recent follow up, 94% of patients in group 1 and 87% in group 2 had normal urine, 6% in group 1 and 13% in group 2 had minor urinary abnormalities, and no patients in either group had active renal disease or renal insufficiency.
  
  
  CONCLUSIONS
  TMP is effective in ameliorating urinary abnormalities and improving the long-term outcome of pediatric IgAN both as an initial and as a rescue treatment.
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Maeda
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Shuto
authors.initials: S
authors.lastname: Kanno
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ohara
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Suyama
authors.affiliation: Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya
mesh_terms: D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: IgA nephropathy; long-term follow up; outcome; pediatrics; tonsillectomy plus methylprednisolone pulse therapy