Association of cyclosporine and mycophenolate mofetil in the treatment of steroid and cyclosporine resistant focal segmental glomerulosclerosis
Background: Focal and segmental glomerulosclerosis is a common cause of nephrotic syndrome. In cases of steroid and cyclosporine resistance several alternatives have been suggested, based on limited studies with conflicting results. Several studies in organ transplantation have shown that the association of cyclosporine and mycophenolate mofetil has a synergic immunosuppressive effect. Clinical cases: We present two cases of nephrotic syndrome due to idiopathic focal segmental glomerulosclerosis with resistance to steroids, cyclosporine plus low -dose steroids and to mycophenolate mofetil in monotherapy in one of them, where complete remission was achieved with the association of cyclosporine and mycophenolate mofetil. There were no significant complications or renal failure during follow-up in both cases. Conclusion: Combined therapy with cyclosporine and mycophenolate mofetil appears to be effective and safe in the treatment of steroid and cyclosporine resistant idiopathic focal segmental glomerulosclerosis
| Main Authors: | , , , , |
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| Format: | Digital revista |
| Language: | English |
| Published: |
Sociedade Portuguesa de Nefrologia
2015
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| Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000100013 |
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| Summary: | Background: Focal and segmental glomerulosclerosis is a common cause of nephrotic syndrome. In cases of steroid and cyclosporine resistance several alternatives have been suggested, based on limited studies with conflicting results. Several studies in organ transplantation have shown that the association of cyclosporine and mycophenolate mofetil has a synergic immunosuppressive effect. Clinical cases: We present two cases of nephrotic syndrome due to idiopathic focal segmental glomerulosclerosis with resistance to steroids, cyclosporine plus low -dose steroids and to mycophenolate mofetil in monotherapy in one of them, where complete remission was achieved with the association of cyclosporine and mycophenolate mofetil. There were no significant complications or renal failure during follow-up in both cases. Conclusion: Combined therapy with cyclosporine and mycophenolate mofetil appears to be effective and safe in the treatment of steroid and cyclosporine resistant idiopathic focal segmental glomerulosclerosis |
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