Cyclosporin A in combination with corticosteroids as a treatment for immunoglobulin A vasculitis nephritis in children
Abstrakt
BACKGROUND: Immunoglobulin A vasculitis is the most common vasculitis in children. It is usually a self-limiting condition, and the long-term prognosis depends on the severity of renal involvement.
Although cyclosporin A is not generally recommended for the management of moderate immunoglobulin A vasculitis nephritis, a few previous reports showed its efficacy. Our aim was to determine whether the treatment with cyclosporin A in combination with corticosteroids is safe and effective for moderate pediatric immunoglobulin A vasculitis nephritis.
METHODS: Nine children underwent treatment. Mean follow-up was 3.1+-1.6 (1.4-5.8) years.
RESULTS: All children (seven females and two males) reached complete remission (65.8+-27.6 [24-99]) days. No patient had relapse, one patient had slightly impaired kidney function (glomerular filtration rate 84.4 mL/min/1.73 m(2)), and two patients had microscopic hematuria without proteinuria at last follow-up.
One patient with delayed treatment had microscopic hematuria at last follow-up and developed early albuminuria after cessation of immunosuppression. We observed no serious complications or side effects of the treatment.
CONCLUSIONS: Cyclosporin A in combination with corticosteroids seems to be a safe and effective treatment for moderate immunoglobulin A vasculitis nephritis. More studies with cyclosporin A should be conducted to better determine the best therapeutic approach.