Tacrolimus for the treatment of focal segmental glomerulosclerosis resistant to cyclosporine A
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We read with great interest the article by Loeffler et al.  referring to the efficacy of tacrolimus (TL) in children with refractory nephrotic syndrome (NS). However, there is little published information on TL treatment of childhood focal segmental glomerulosclerosis (FSGS) [1, 2]. In this letter, we report on two pediatric patients with cyclosporine A (CsA)-resistant FSGS in whom successful and rapid clinical remission and reduction in the dose of prednisolone (PSL) were achieved following TL treatment.
A 9-year-old Japanese boy was referred to our hospital with a 2-month history of unremitting steroid-resistant proteinuria. A percutaneous renal biopsy revealed lesions characteristic of FSGS. Despite aggressive immunosuppressive therapy, such as methylprednisolone pulse therapy (MPT), and therapy with cyclophosphamide (CPM), mizoribine (MZR) and CsA at the dose of 5.0 mg/kg daily , the heavy proteinuria persisted for the next 6 months. The trough blood level of CsA...
KeywordsCyclosporine Tacrolimus Nephrotic Syndrome Clinical Remission Severe Adverse Effect
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