Abstract
Although there are some reports that cyclosporine A (CsA) is effective for Henoch-Schönlein purpura nephritis (HSPN), there are a few reports in Japan and the effectiveness of CsA for HSPN remains to be elucidated. The objects of our study were 6 patients with refractory HSPN, who satisfied the diagnostic criteria of nephrotic syndrome and suffered from lasting heavy proteinuria even after starting the treatment including prednisolone (PSL). We added CsA for these patients and analyzed the effectiveness. The average age was 6.9 years old, and the average administration period of CsA was 2.6 years. Proteinuria disappeared and pathological findings of kidney were improved in all the 6 cases. CsA could be effective enough under the following conditions of the early initiation of CsA treatment and the usage of both PSL and ACE inhibitor together. The safe and appropriate period of using CsA was considered to be 2 years with the target trough level of 50–90 ng/ml. Although it is necessary to appropriately choose which HSPN case should be treated with CsA, CsA can surely be one of the immunosuppressants to use for refractory HSPN accompanied with lasting heavy proteinuria after the treatment including PSL.
