Immunosuppressive Therapy of Chronic Renal Disease

Michael, Alfred F.; Vernier, Robert L.; Drummond, Keith N.; Levitt, John I.; Herdman, Roger; Fish, Alfred J.; Good, Robert A.

doi:10.1056/nejm196704132761501

Cited by 96 publications

(19 citation statements)

References 16 publications

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“…Deposition of IgG and betalcglobulin was seen along the glomerular basement membranes. These patients all failed to respond to conventional doses of corticosteroids, but several did respond to subsequent large doses of immunosuppressive agents, among them prednisone (14). Group III constitutes only a relatively small proportion of children with the nephrotic syndrome.…”

Section: Discussionmentioning

confidence: 99%

The nephrotic syndrome of childhood: immunologic, clinical, and pathologic correlations.

Drummond¹,

Michael²,

Good³

et al. 1966

J. Clin. Invest.

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Section: Discussionmentioning

confidence: 99%

The nephrotic syndrome of childhood: immunologic, clinical, and pathologic correlations.

Drummond¹,

Michael²,

Good³

et al. 1966

J. Clin. Invest.

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“…In addition to HN2 [4,13,24,26,43], corticosteroids have been used in combination with other drugs (table IV); thioguanine [10,12], 6-mercaptopurine [31,45], azathioprine [2,8,12,22,29,32,35,46,47,50], cyclophospha mide [5,9,22,48,51], methotrexate [9], thiomycetin [49] or chlorambucil [4,22]. Bariety et al [4] deliberately used LDS with a combination of an alkalyting agent (HN2 or chlorambucil) and an antimetabolite (cyclophosphamide or 6-mercaptopurine).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Treatment with Prednisone and Nitrogen Mustard on the Renal Lesions and Life Span of Patients with Lupus Glomerulonephritis

Dillard¹,

Dujovne²,

Pollak³

et al. 1973

Nephron

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In 17 patients, active (diffuse) lupus glomerulonephritis was treated with a combination of mechlorethamine (HN₂) and a high dose of corticosteroids (HDS). Serial clinical and sequential histologic observations were made. The results were compared with those from a previously reported and comparable group of patients who were treated with HDS alone. The mortality rate seen in the more severely affected patients was similar in both groups and there was no significant difference in estimated survival. By contrast, in those in whom the kidneys were less severely affected, the estimated survival appeared to be better in those treated with HDS-HN₂. Control of histologic activity also occurred more rapidly in the HDS-HN₂ group.

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“…Lipoid nephrosis rarely appears to respond whereas appoximately a third of patients with membranous nephropathy and systemic lupus erythematosus show improvement [28]. Judgement must be reserved until further ex perience is accumulated.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Correlations in Idiopathic Nephrotic Syndrome with Membranous Nephropathy

Forland

Spargo

1969

Nephron

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The separation of patients with idiopathic nephrotic syndrome into those with lipoid nephrosis and membranous nephropathy on the basis of ultrastructural study of renal biopsy material is supported by contrasts in the natural history and response to therapy of the groups. Nineteen patients with the latter lesion have been followed for periods of up to eleven years. Nine are known to have expired with a mean duration of clinical illness of six years. Nine survivors are known with a mean duration of clinical illness of 5.3 years. Corticosteroid therapy rarely appears to provide sustained clinical improvement. However, remissions with loss of clinical features of the illness have been observed in five patients. Serial renal biopsies indicate the morphologic lesion is usually unchanged or progressive, despite subsidence of proteinuria and clinical remission. In one patient a renal biopsy in her third year of remission showed striking regression of a previously marked membranous change. Morphologic differentiation from renal involvement with systemic lupus erythematosus may be difficult and diagnosis depends on evidence of multisystem disease and additional laboratory studies. Review of reported immunofluorescent studies of biopsy material and comparison with experimental lesions suggest the glomerular membranous lesion is immunologically determined.

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Immunosuppressive Therapy of Chronic Renal Disease

Cited by 96 publications

References 16 publications

The nephrotic syndrome of childhood: immunologic, clinical, and pathologic correlations.

The nephrotic syndrome of childhood: immunologic, clinical, and pathologic correlations.

The Effect of Treatment with Prednisone and Nitrogen Mustard on the Renal Lesions and Life Span of Patients with Lupus Glomerulonephritis

Clinicopathological Correlations in Idiopathic Nephrotic Syndrome with Membranous Nephropathy

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