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Effectiveness of high trough levels of cyclosporine for 5 months in a case of steroid‐dependent nephrotic syndrome with severe steroid toxicity
Author(s) -
KANO KENICHI,
YAMADA YUMI,
SHIRAIWA TAEKO,
SHIMIZU AKI,
NISHIKURA KIYOSHI,
ARISAKA OSAMU,
TOMITA SHIGEKI,
UEDA YOSHIHIKO
Publication year - 2004
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2004.00341.x
Subject(s) - medicine , prednisolone , discontinuation , nephrotic syndrome , steroid , adverse effect , glucocorticoid , surgery , anesthesia , gastroenterology , hormone
SUMMARY: Glucocorticoid treatment for steroid‐dependent nephrotic syndrome (NS) is associated with severe adverse effects, such as bone fractures and epidural lipomatosis. Furthermore, a high trough level of cyclosporine (CsA) over an extended period of time is known to induce CsA nephropathy. We present a girl with steroid‐dependent NS and steroid‐induced vertebral compression fractures and epidural lipomatosis who was treated with a high‐dose of prednisolone after experiencing several relapses. A high CsA trough level (between 147 and 225 ng/mL) over a period of only 5 months was effective in improving the vertebral compression fractures, alleviating the epidural lipomatosis by enabling the discontinuation of prednisolone treatment. Thus, high trough levels of CsA over a short period of time may enable prednisolone to be discontinued in cases of steroid‐dependent NS without causing any clinical, histological, serum and/or urinary CsA‐related adverse effects.