Paucity of Minimal-Change Lesion in Children with Early Frequently Relapsing Steroid-Responsive Nephrotic Syndrome
作者:
Howard Trachtman,
Fred Carroll,
Kishore Phadke,
Mohammed Khawar,
Anthony Nicastri,
C.K. Chen,
Amir Tejani,
期刊:
American Journal of Nephrology
(Karger Available online 1987)
卷期:
Volume 7,
issue 1
页码: 13-17
ISSN:0250-8095
年代: 1987
DOI:10.1159/000167422
出版商: S. Karger AG
关键词: Minimal-change lesion;Nephrotic syndrome;frequently relapsing;steroid responsive
数据来源: Karger
摘要:
It is widely believed that the most common morphological lesion in children with the idiopathic nephrotic syndrome who manifest a frequently relapsing steroid-responsive course is the minimal-change lesion. However, there are no prospective renal biopsy studies in such patients to substantiate this assertion. We performed a renal biopsy in all children with early frequently relapsing steroid-responsive nephrotic syndrome during the years 1980–1984. In 16 affected children, only 4 (25%) had minimal-change lesion, 7 had IgM nephropathy, 3 had diffuse mesangial hypercellularity, and 2 had focal segmental glomerulosclerosis. Fourteen of these patients have required immunosuppressive therapy with cyclophosphamide. Long-term follow-up revealed that 10 patients have remained protein free, 4 have persistent proteinuria despite cyclophosphamide therapy, 1 had progressed to end-stage renal disease, and 1 is lost to follow-up. On the basis of these findings, we recommend that all children with nephrotic syndrome and an early frequently relapsing steroid-responsive course undergo a prompt renal biopsy. Such patients constitute a high-risk group with a spectrum of renal histopathological lesions characterized by an unpredictable response to therapy and an unfavorable prognosi
点击下载:
PDF
(1057KB)
返 回