The 26 children with idiopathic nephrotic syndrome, included 8 fresh cases, were treated by 2-3 hours intravenous infusion of betamethasone 2mg/kg or methylprednisolone 20mg/kg in 5% glucose solution 100-200ml for 3 consecutive days, as one course of therapy. Sixty-five courses of “pulse” therapy were performed, of which betamethasone was used in 48 cases and methylprednisolone was in 17 cases. The age of patients distributed form three to fifteen years. Renal biopsies were performed in 20 cases, which included minor glomerular abnormalities, mild diffuse proliferative mesangial glomerulonephritis (GN), moderate diffuse proliferative mesangial GN, focal glomerular sclerosis, comprising eight, eight, one and three cases, respectively. The results are as follows : 1) There was no difference between betamethasone and methylprednisolone, in effects and adverse reactions. 2) In the fresh cases or the exacerbated cases after discontinuation of corticosteroids, 1 to 3 courses of the “pulse” therapy remitted 78% of the cases, of which in some cases three courses of “pulse” therapy was followed by oral prednisolone 0.5-1.0 mg/kg/day. 3) In the exacerbated cases under corticosteroid administration, one course of “pulse” therapy induced remission in about a half of the cases. 4) The duration of remitted period induced by “pulse” therapy is not correlated with the change of peripheral lymphocyte count, the selectivity of proteinuria, or the interval required for remission. 5) One patient had become hypovolemic shock because of massive diuresis after “pulse” therapy, then plasma derivatives was used prophylactically. Other serious adverse reactions were not seen. 6) They are further problems that the optimal method of corticosteroids therapy in each nephrotic child is decided by the reactivity to “pulse” therapy, and that the prognosis is evaluated by the reactivity.
