Cyclosporin A mono-therapy in nephrotic syndrome with contra-indication of steroid therapy.

We describe three cases of nephrotic syndrome with a contra-indication for steroid therapy successfully treated with cyclosporin A (CsA). A 21-year-old man with focal segmental glomerulosclerosis (FSGS) complicated by necrosis of the femoral head, and a 34-year-old woman and a 48-year-old man with minimal change disease (MCD) complicated by psychogenic reaction and diabetes mellitus, respectively, were given CsA at initial dosages of 3.8-5.0 mg/kg/day and immediately remitted completely. However, two of these patients suffered relapses when CsA was tapered. They are currently maintained in complete or partial remission on CsA at dosages of 3.2-4.7 mg/kg/day. These findings suggest that CsA mono-therapy may be useful in nephrotic syndrome patients contra-indicated for steroid therapy.

[1]  D. Milford,et al.  Cyclosporin A therapy in frequently relapsing nephrotic syndrome and IgA nephropathy. , 1997, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[2]  A. Meyrier,et al.  Long-term renal tolerance of cyclosporin A treatment in adult idiopathic nephrotic syndrome † , 1994 .

[3]  M. Mihatsch,et al.  Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. , 1992, The New England journal of medicine.

[4]  H. Makino,et al.  A case of early-stage diabetic nephropathy complicated by minimal change nephrotic syndrome treated with cyclosporin A. , 1997, Nephron.

[5]  P. Rémy,et al.  Long-term cyclosporin A therapy for severe idiopathic membranous nephropathy. , 1993, Nephron.

[6]  A. Meyrier Treatment of glomerular disease with cyclosporin A. , 1989, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.