ESPN 50th Annual Meeting

ESPN 2017


 
EFFICIENCY OF CYTOSTATIC THERAPY FOR RELAPSING AND FREQUENTLY RELAPSING STEROID DEPENDENT NEPHROTIC SYNDROME (SDNS) IN CHILDREN
POLINA NYRKOVA 1 NADEZHDA SAVENKOVA 1

1- SAINT-PETERSBURG STATE PEDIATRIC MEDICAL UNIVERSITY, RUSSIAN FEDERATION
 
Introduction:

The aim of the study was to assess the efficiency of cytostatic therapy in children with SDNS.

Material and methods:

Out of total 168 children with initial Steroid-Senstive NS, 70 (41,7%) became relapsing and frequently relapsing with steroid dependence and toxicity. The mean age of SSNS diagnosis was 3,6┬▒0,7 years, with a male/female ratio of 2:1. We analysed frequency of relapses in children with SDNS during 2 years after cytostatic therapy.

Results:

All 70 children with SDNS had increased specific IgE to alimentary allergens (100%), 47 (67,1%) - to dust allergens, grasses and trees pollen allergens, 41 (58,6%) children had clinical manifistations of allergy. Out of 70 children with SDNS, 54 were treated with steroid-sparing agents: 28 - đílorambucil 0,15-0,3 mg/kg/day during 2-3 months, 17 - Cyclosporin A (CsA) 2,5-5 mg/kg/day (including 3 after Clorambucil) and 21 - Mycophenolate mofetil (MMF) (including 3 after Clorambucil and CsA; 6 after CsA; 3 after Clorambucil) during 3-6 months. Out of 28 children treated with Clorambucil, 17 (60,7%) had relapses; out of 17 children treated with CsA, 15 (88,2%) had relapses; out of 21 children treated with MMF, 10 (47,6%) had relapses during 2 years after cytostatic therapy. Out of 54 children 24 (44,4%) had no relapses of SDNS during 2 years after cytostatic therapy.

Conclusions:

Children with increased specific IgE to allergens and clinical manifistations of allergy had subsequent relapses of SDNS after cytostatic therapy with Clorambucil, CsA, MMF.