Abstract
The treatment of steroid-resistant minimal change nephrotic syndrome (MCNS) continues to pose a therapeutic challenge. We conducted a randomised prospective controlled trial to evaluate the efficacy of IV cyclophosphamide compared with oral cyclophosphamide in 13 children with biopsy-proven steroid-resistant MCNS. All 7 patients receiving IV cyclophosphamide achieved remission; this was sustained in 4 patients, while 3 relapsed. However, even these 3 patients subsequently became steroid sensitive. Of the 6 patients who received oral cyclophosphamide, 2 dropped out, 1 responded and 3 children continued to remain steroid resistant. The children who received IV cyclophosphamide had more sustained remissions, longer periods without proteinuria and fewer significant side effects; this was achieved at a lower cumulative dose.
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Elhence, R., Gulati, S., Kher, V. et al. Intravenous pulse cyclophosphamide — a new regime for steroid-resistant minimal change nephrotic syndrome. Pediatr Nephrol 8, 1–3 (1994). https://doi.org/10.1007/BF00868243
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DOI: https://doi.org/10.1007/BF00868243