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| 신증을 동반한 HSP 신염에서 Cyclosporin A의 치료효과 |
| 권민중 , 김병길 , 정현주 , 최인준 |
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| Abstract |
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Treatment of Henoch-Schonlein purpura nephritis (HSPN) accompanied by nephrotic syndrorne(NS) is still controversial, even though both corticosteroids and immunosuppressants have been used for therapy. Cyclosporin A(CsA) is a neutral lipophilic endecapeptide that inhibits the production and/or release of interleukins, and is used in steroid- resistant nephrotic syndrome. We studied the effects of CsA in HSPN accompanied by NS. The study was done by evaluating the clinical status and histopathological changes by sequential biopsies following the treatment. All patients developed nephrotic syndrome either initially or during the course of HSPN. They were treated with CsA (5mg/kg/day) and prednisolone (1mg/kg/q.o.d.) for 6 to 8 months. The clinical status of the patients on admission were C(16 cases) and D(1 case), but changed to B(11 cases) and A(6 cases) following treatment. All cases displayed no proteinuria 3.3±1.7 months after treatment. During 16.6±8.1 months of follow-up, 10 cases presented complete remission, one recurred NS, and one progressed to ESRD and was done transplantation. The remaining cases had persistant mild proteinuria and hernaturia. Histopa- thologically, 5 cases improved, 2 aggravated, and the remaining not changed in the grading system by ISKDC. But irnmunopathologically, 16 out of 17 cases decreased intensity and extent of immune deposits. This study suggests that, although control studies are needed, CsA could be used in the treatment of HSPN accompanied by NS. |
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