A case of nephrotic syndrome who remitted by change of the internal use method of cyclosporine A

Abstract

A 12-year-old girl with nephrotic syndrome since 7 years old, repeated recurrence despite administration of prednisolone (PSL) and cyclosporine A (CyA). Her blood concentration levels of CyA have been monitored regularly. But the level was relatively low (C0 70 ng/ml, C2 500 ng/ml) considering the dose (7.7 mg/kg/day in two divided doses), and unstable. We found out that her medication was always after meal and the timing was irregular. She was advised to take CyA at a fixed time 30 minutes before meals. As a result, her blood concentration levels of CyA elevated markedly and stabilized. Consequently, she has succeeded in reducing dosage of CyA. It is important not only to monitor blood concentration regularly but also to check on the medication status of a patient, and advise appropriate oral medication.