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IgA 신병증에 의한 신증후군에서 면역억제제 치료에 대한 반응 |
안재형 , 김세윤 , 이태원 , 임천규 , 김명재 |
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Abstract |
IgA nephropathy is the most frequent primary glomerular disease in many countries, including Korea, throughout the world. Nephrotic syndrome in IgA ne- phroathy has been known as a important predictor of prognosis, but there were no consistent views on the therapeutic response. We reviewed 17cases of IgA nephropathy with en- phrotic syndrome in Kyung Hee University Hospital from January 1981 to May 1988 and evaluated the thera- peutic response of prednisolone therapy and combina- tion therapy with prednisolone and cyclophosphamide in steroid resistant patients retrospectively. The results were summarized as follows; 1) Complete remission was obstained in 100% of the prednisolone therapy group, 45% of the combination therapy group, and 65% of the total subjects. Partial remission was obtained in 29% of the total subjects and no remission was obtained in 6/o of the total subjects. 2) All of the subjects with reduced renal function (3 patients) were partial responder or nonresponders. 3) Primary response was 86% (6/7) in subjects with histologic Grade 1,38% (3/8) in that with Grade II, 100% (2/2) in that with Grade III, In conclusion, patients with IgA nephropathy with nephrotic syndrome may respond more slowly and less completely to both prednisolone and cyclophosphamide than those with minimal change nephrotic syndrome. Partial or nonresponder may be a predictor of poor prognosis. |
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