ESPN 51th Annual Meeting

ESPN 2018


 
Rescue treatment of corticoresistant nephrotic syndrome: a case report
FERJANI MARYEM HAMMI YOUSRA BOUSETTA ABIR 1 ELGAZZEH SOUHIR 1 JELLOULI MANEL 1 GARGAH TAHAR 1

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY OF CHARLES NICOLLE, TUNIS,TUNISIA
 
Introduction:

 

The corticoresistant nephrotic syndrome can in some cases be difficult to manage. Our goal is to study the efficacy of repeated pulses of methylprednisolone in this situation.

Material and methods:

 

We report the case of a patient in the pediatric department of Charles Nicolle Hospital that had a corticoresistant nephrotic syndrome with a delayed response to cyclosporin.

Results:

 

B.R was admitted in the pediatric department for a nephrotic syndrome at the age of 2 years and one month .She had a corticoresistance so she recieved cyclosporin. Despite regular drugs intake and a cyclosporin plasma level in the therapeutic range,she did not show any biological improvement after 2 months with of persistant massive proteinuria at more than 12 gr / 24hours. She kept an important oedemato-ascitic syndrome and functional renal failure with urea  exceeding 33mmol / l despite regular albumin infusions . It was then decided to renew the 3 pulses of methylprednisolne monthly. Between the pulses she had been kept under discontinuous oral corticosteroids. She had a progressive improvement of the nephrotic syndrome with obtaining a remission at the end of the 9th pulse .After the 10 pulses she was kept under discontinuous oral corticosteroid with progressive decreasing  and stop after 2 years and a half. Actually the patient still takes cyclosporin and doesn’t had any relapse.

Conclusions:

 

In the corticoresistant nephrotic syndrome pulses of methylprednisoslone  can be a rescue treatment and may protect from the nephrotic syndrome complications.