The Nephrotic Syndrome in Children Treated with A.C.T.H. and Cortisone

Mf, McCALL; Ross, Alastair; Wolman, B.; Ad, Burns; Em, Harpur; Goldbloom, Alton

doi:10.1136/adc.27.134.309

Cited by 15 publications

(6 citation statements)

References 14 publications

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“…Since cortisone was given for a standard period of five days it is not possible to say that diuresis would not have occurred had treatment been continued longer. However, this finding has also been recorded by McCall, Ross, Wolman, Burns, Harpur and Goldbloom (1952) and Luetscher, Deming and Johnson (1951), who found that diuresis did not occur during the administration of cortisone. Although diuresis was provoked by these hormones on 15 occasions in all, only in five instances did loss of oedema persist for more than six months and in one of these five children albuminuria remained present.…”

Section: Treatmentsupporting

confidence: 77%

A.C.T.H in Nephrosis

Arneil¹,

Wilson²

1953

Archives of Disease in Childhood

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Section: Treatmentsupporting

confidence: 77%

A.C.T.H in Nephrosis

Arneil¹,

Wilson²

1953

Archives of Disease in Childhood

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“…In many patients with the nephrotic syndrome, proteinuria diminished during or after treatment with corticotropin (ACTH) or Cortisone (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Further, in most patients so treated GFR increased (6)(7)(8)12).…”

mentioning

confidence: 99%

The Effect of Corticotropin (ACTH) on Glomerular Permeability to Albumin in Children with the Nephrotic Syndrome 12

Lauson¹,

Forman²,

McNamara³

et al. 1954

J. Clin. Invest.

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Present evidence indicates that proteinuria in patients with the nephrotic syndrome is the result of increased permeability of the glomerular capillary walls to proteins, particularly to albumin (1, 2). A rough indication of the permeability to albumin, relative to permeability to water, is provided by the ratio of the concentration of albumin in glomerular fluid to that in plasma. Assuming that no albumin is excreted by the tubules, the rate of albumin excretion (in mg. per min.) divided by the rate of glomerular filtration of water (GFR, in ml. per min.) represents the lowest possible concentration of albumin in glomerular fluid (in mg. per ml.) ; if some albumin is reabsorbed by the tubules, as seems likely, the actual concentration of albumin in glomerular fluid would be greater than this calculated value. If it is accepted that the clearance of inulin (CIN) is equivalent to GFR in children with the nephrotic syndrome (3), it follows that the renal clearance of albumin (CALB) divided by CIN, i.e., CALB/CIN, represents the minimum ratio of the albumin concentration in glomerular fluid to that in plasma. Chinard, Lauson, and Eder (4) showed that in patients with the nephrotic syndrome the renal clearance of the blue dye, T-1824 (CT_1824), was somewhat less than but approximately proportional to CALB. It would appear, therefore, that where large changes in permeability are expected CT_1824should be a satisfactory substitute for CALB. The

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“…Pediatric experience with corticosteroids also started in these years: for example, in 1951 the British Medical Journal described fi ve children (three with rheumatoid arthritis, one with acute rheumatic carditis, one with nephrosis) treated with oral cortisone [ 5 ]. In the same year, seven other children with nephrotic syndrome were treated with cortisone [ 6 ]. Between 1954 and 1958, six synthetic steroids were introduced for systemic anti-infl ammatory therapy.…”

Section: Systemic Corticosteroids For Autoimmune/ Infl Ammatory Disormentioning

confidence: 97%

Systemic Corticosteroids for Autoimmune/Inflammatory Disorders in Children: Introduction

Saggese

Vierucci²

2015

Systemic Corticosteroids for Inflammatory Disorders in Pediatrics

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More than six decades have elapsed since the introduction of corticosteroids into the pharmacologic armamentarium of pediatricians. Despite the widespread clinical use of these agents for many years, several questions remain concerning their appropriate therapeutic role, indications, possible regimens, and adverse effects. The discovery of corticosteroids can be considered one of the most important therapeutic revolutions of the last century. Steroids became crucial for the treatment of several infl ammatory and rheumatic diseases, including diseases that occur during childhood. However, the great enthusiasm over the discovery of corticosteroids was hampered in later years by the identifi cation of important side effects that raised concerns regarding steroid therapy. Thus, in the past years, research focused on the development of new steroid compounds with lower toxicity and higher effi cacy as well as on novel therapeutic regimens. Now, 60 years later, treatment with corticosteroids has stood the test of time, and despite the well-known side effects they are still a keystone in the therapy of many disorders and can sometimes be life-saving [ 1 ].In 1930, for the fi rst time an extract of animal adrenocortical tissue was demonstrated to counter human adrenal failure. Subsequently, following chemical analyses of cortical extracts, it became clear that there was not one cortical hormone, but several steroid hormones. By 1940 two categories of corticosteroids were identifi ed: those that caused sodium and fl uid retention (mineralocorticoids) and those that opposed shock and infl ammation (glucocorticoids) [ 2 ]. Extractive chemistry, chemical synthesis, and clinical investigations were combined, resulting in the discovery of cortisone and a long series of related derivatives [ 3 ]. P. Hench postulated that an antirheumatic chemical, or "substance X," was produced in response to stress. In

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The Nephrotic Syndrome in Children Treated with A.C.T.H. and Cortisone

Cited by 15 publications

References 14 publications

A.C.T.H in Nephrosis

A.C.T.H in Nephrosis

The Effect of Corticotropin (ACTH) on Glomerular Permeability to Albumin in Children with the Nephrotic Syndrome 12

Systemic Corticosteroids for Autoimmune/Inflammatory Disorders in Children: Introduction

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