Effect of Methylprednisolone Pulse Therapy on Cellular Immunity Abnormalities in a Patient with Lipoid Nephrosis

Koichi Matsumoto, MD, 2nd Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-KamiMachi, Itabashi-ku, Tokyo 173 (Japan) Dear Sir, The pathogenesis of lipoid nephrosis (LN) is obscure. It has been postulated that this glomerular disease may be a systemic disorder of cell-mediated immunity (CMI) [1, 2]. Initially used in the treatment of renal transplant rejection, intravenous pulse methylprednisolone (PM) therapy has been used to treat patients with the nephrotic syndrome (NS) [3]. However, to our knowledge, there is little information available about the effect of PM therapy on CMI in LN patients. The aim of this study was to evaluate the effect of PM therapy on CMI parameters in a LN patient. A 17-year-old previously healthy boy developed idio-pathic NS. Urinalysis revealed 4+ protein, and the urine output was 500 ml during the first 24 h. On admission, his blood pressure was normal. Serum albumin was 2.2 g/dl, 24-hour creatinine clearance 138.8 ml/min, blood urea Pulse therapy (1,0O0 mg/day) 1⁄8dn‚solone 60 mg3⁄45⁄8 \ \ J||P > edπlsolone 40 ^:§Pg«1⁄8^í”Lmíw^,^íuαí > íum 8 9 August 1989 September 1989 Fig. 1. Variation of responses to treatment with PM in a LN patient. The shaded area represents the normal range. 340 Matsumoto/Ito/Abe