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Nephrotic syndrome after conversion to alternate day steroids in two children with a history of recurrent FSGS
Author(s) -
Hanevold Coral D.,
Greenbaum Larry A.
Publication year - 2003
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1034/j.1399-3046.2003.00112.x
Subject(s) - medicine , plasmapheresis , prednisone , nephrotic syndrome , immunosuppression , focal segmental glomerulosclerosis , transplantation , pediatrics , kidney transplantation , kidney disease , surgery , kidney , glomerulonephritis , immunology , antibody
FSGS is a common indication for kidney transplantation in children. However, transplantation is often complicated by recurrence of FSGS in the transplanted kidney, resulting in nephrotic syndrome and an increased risk of graft loss. Acute treatment strategies for recurrent FSGS include plasmapheresis and increased immunosuppressive therapy. There is little information on the long‐term management of immunosuppression in these patients. We describe two children who were successfully treated with plasmapheresis for recurrent FSGS that occurred immediately post‐transplant. Nephrotic syndrome reappeared years later when the patients were converted from daily to alternate day prednisone. In children with a history of FSGS, caution is necessary when altering the dosing schedule of prednisone.