MedicineNephrologyPediatricsPediatric NephrologyRenal PathologyRenal PharmacotherapyGlomerular Disease PharmacotherapyGlomerular DiseasesPediatric Renal PathologyRenal DiseaseRenal ImmunopathologyGlomerular HistopathologyHistologic RemissionIga Nephropathy TherapyMesangial Cell ProliferationMesangial ProliferationPediatric Glomerular DiseasePediatric Renal BiopsyPrimary Glomerular Diseases
AIMS: IgA nephropathy is one of the most common glomerular diseases in children. The aim of this study was to investigate the clinical and pathologic efficacy of methylprednisolone and cyclophosphamide in the treatment of primary pediatric IgA nephropathy. METHODS: 11 patients with renal-biopsy-diagnosed Grade IV IgA nephropathy were treated with methylprednisolone and cyclophosphamide. Pathological changes were evaluated by post-treatment renal biopsies. RESULTS: At follow-up (18 - 60 months post-treatment), 6 patients were in complete remission. For the remaining 5, treatment was rated "markedly effective." Renal biopsies showed less mesangial proliferation, significantly decreased crescent formation, reduced segmental sclerosis, and significantly reduced mesangial IgA deposition. CONCLUSIONS: Methylprednisolone and cyclophosphamide in children with Grade IV IgA nephropathy stabilized renal function and significantly reduced hematuria, proteinuria, mesangial IgA deposition, and the renal pathological activity index.