Remission of resistant MPGN type I with mycophenolate mofetil and steroids

Sudarsana De, Dana Al-Nabhani, Paul Thorner, Daniel Cattran, Tino D. Piscione, Christoph Licht

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Very few studies have been published on how to treat children with membranoproliferative glomerulonephritis type I (MPGN I), and as yet there is only one report on the use of mycophenolate mofetil (MMF) in children with MPGN I. We report a 12-year-old boy who presented with edema, hypertension, nephrotic range proteinuria, and microscopic hematuria following an upper respiratory tract infection. Laboratory tests revealed a serum creatinine of 90 μmol/l, albumin of 20 g/l, and a C3 of 0.11 g/l (normal range: 0.7-1.4). Renal biopsy showed the presence of MPGN I. Upon failure to induce remission with prednisone, we started the patient on MMF at 500 mg/day (300 mg/m2), increasing up to a final dose of 2 g/day (1200 mg/m2), with a MMF metabolite mycophenolic acid (MPA) target range of 2-5 mg/l. Prednisone was subsequently reduced to alternate day therapy and gradually weaned to 7.5 mg on alternate days over 9 months. Within 4 months of starting MMF therapy, there was significant improvement in serum creatinine (decrease from 156 to 64 μmol/l), serum albumin (increase from 23 to 40 g/l), and proteinuria (decrease from 13 g/day to 40 mg/day). Twelve months following the introduction of MMF into his therapeutic regimen, he remains in remission with no further relapses. In summary, this case suggests that there may be potential benefit for use of MMF in children with refractory MPGN I, which supports the rationale for prospectively evaluating MMF treatment in a treatment trial of refractory MPGN I.

Original languageEnglish
Pages (from-to)597-600
Number of pages4
JournalPediatric Nephrology
Volume24
Issue number3
DOIs
Publication statusPublished - 2009

Fingerprint

Mycophenolic Acid
Membranoproliferative Glomerulonephritis
Steroids
Prednisone
Proteinuria
Creatinine
Therapeutics
Hematuria
Serum
Serum Albumin
Respiratory Tract Infections
Albumins
Edema
Reference Values
Hypertension
Kidney
Biopsy
Recurrence

Keywords

  • Membranoproliferative glomerulonephritis type I
  • Mycophenolate mofetil
  • Prednisone
  • Proteinuria

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Remission of resistant MPGN type I with mycophenolate mofetil and steroids. / De, Sudarsana; Al-Nabhani, Dana; Thorner, Paul; Cattran, Daniel; Piscione, Tino D.; Licht, Christoph.

In: Pediatric Nephrology, Vol. 24, No. 3, 2009, p. 597-600.

Research output: Contribution to journalArticle

De, Sudarsana ; Al-Nabhani, Dana ; Thorner, Paul ; Cattran, Daniel ; Piscione, Tino D. ; Licht, Christoph. / Remission of resistant MPGN type I with mycophenolate mofetil and steroids. In: Pediatric Nephrology. 2009 ; Vol. 24, No. 3. pp. 597-600.
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