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2016 ; 41
(3
): 243-247
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Levamisole therapy in children with frequently relapsing and steroid-dependent
nephrotic syndrome: a single-center experience
#MMPMID27833440
Ku?ma-Mroczkowska E
; Skrzypczyk P
; Pa?czyk-Tomaszewska M
Cent Eur J Immunol
2016[]; 41
(3
): 243-247
PMID27833440
show ga
INTRODUCTION: Numerous studies suggest that levamisole, an antihelmintic agent
with an immunomodulatory effect, reduces the number of relapses in children with
frequently relapsing and steroid-dependent nephrotic syndrome (FRNS/SDNS). The
aim of the study was to present a single center's experience in treatment of FRNS
and SDNS with levamisole. MATERIAL AND METHODS: Among 72 children with FRNS/SDNS
treated in our department with levamisole in the years 1984-2011 we studied in
detail 53 patients (mean age: 6.5 ±3.0 years), in whom the medication was
administered for at least 6 months. In these 53 patients we evaluated: the course
of the disease before levamisole, the renal biopsy result, medications used,
prednisone dose on levamisole initiation, duration of levamisole treatment, time
to first relapse and number of relapses on levamisole, and levamisole side
effects. RESULTS: The duration of nephrotic syndrome was 3.4 ±2.9 years, and the
number of relapses before levamisole treatment was 6.0 ±3.4. The dose of
prednisone on initiation of levamisole treatment was 1.2 ±0.6 mg/kg/24 h, and the
duration of levamisole treatment was 15.0 ±7.3 months. During levamisole
treatment proteinuria relapsed in 34/53 (64.2%) children, and the time to first
relapse was 8.8 ±8.1 months. During levamisole therapy relapses of the disease
decreased significantly (2.7 ±2.0 vs. 1.8 ±2.1 relapses/year, p = 0.02). Time to
first relapse correlated with total number of relapses (R = -0.59, p < 0.001) and
number of relapses in one year during levamisole treatment (R = -0.60, p <
0.001). CONCLUSIONS: Levamisole is effective in reducing the number of relapses
in children with frequently relapsing and steroid-dependent nephrotic syndrome.
Early relapse of proteinuria on levamisole treatment in children with FRNS/SDNS
suggests low efficacy of further treatment.