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Long-term follow-up of atypical membranoproliferative glomerulonephritis: are steroids indicated?

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Abstract

Atypical membranoproliferative glomerulonephritis (MPGN) has been reported to have a good prognosis when treated with corticosteroids. However, this recommendation is based on uncontrolled trials and is associated with many complications. The purpose of our study is to determine whether steroid therapy is indicated for atypical MPGN. The cases of seven patients with atypical MPGN are reported in this study. Urinary abnormalities of five of them were detected by urine screening at school, of two because of macrohematuria. Hypocomplementemia was noted in six patients. All but one patient were treated without corticosteroids, and five with angiotensin-converting enzyme inhibitors (ACEI) and/or the Chinese herbal medicine Sairei-to (TJ-114). One patient recovered spontaneously from proteinuria and was therefore not treated, and one who developed severe proteinuria during observation was treated with corticosteroids. After an average follow-up period of 10.0 years, five patients showed normal urinary findings, one had hematuria and one proteinuria. At the most recent follow-up, the renal function of all patients remained within the normal range, and serum C3 had returned to normal levels in five out of six. These findings suggest that the indication of steroid therapy for atypical MPGN should be re-examined, since most of the patients with atypical MPGN seem to have an excellent prognosis without treatment with corticosteroids.

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Authors and Affiliations

  1. Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho Chuo, 6500017, Kobe, Hyogo, Japan

    Teruo Fujita, Kandai Nozu, Ichiro Kamioka & Masafumi Matsuo

  2. Department of Nephrology, National Center for Child Health and Development, Setagaya, Tokyo, Japan

    Kazumoto Iijima

  3. Department of Nephrology, Hara Genitourinary Hospital, Kobe, Hyogo, Japan

    Kunihiko Yoshiya

  4. Department of Nephrology, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan

    Ryojiro Tanaka

  5. Department of Pediatrics, Himeji Red Cross Hospital, Himeji City, Hyogo, Japan

    Kiyoshi Hamahira

  6. Department of Pediatrics, Wakayama Medical University, Wakayama City, Wakayama, Japan

    Koichi Nakanishi & Norishige Yoshikawa

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  1. Teruo Fujita
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  2. Kandai Nozu
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  3. Kazumoto Iijima
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  8. Koichi Nakanishi
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  9. Norishige Yoshikawa
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  10. Masafumi Matsuo
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Correspondence to Teruo Fujita.

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Fujita, T., Nozu, K., Iijima, K. et al. Long-term follow-up of atypical membranoproliferative glomerulonephritis: are steroids indicated?. Pediatr Nephrol 21, 194–200 (2006). https://doi.org/10.1007/s00467-005-2074-7

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  • DOI: https://doi.org/10.1007/s00467-005-2074-7

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