Punit G
Pt. Jawaharlal Nehru Memorial Medical College, India
Title: A study of treatment of steroid resistance and steroid dependent nephrotic syndrome by Mycophenolate mofetil & deflazacort in pediatric age group –a study from developing country (India)
Biography
Biography: Punit G
Abstract
Introduction: Idiopathic nephrotic syndrome affects 1-3 per 100,000 children <16 years of age; whereas most children will be responsive to corticosteroid therapy, approximately 20% will be classified as steroid resistant i.e., failure to achieve complete remission after initial therapy with corticosteroids. Method: The study was conducted in the Department of Medicine, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur. 28 patient of pediatric age group of nephrotic syndrome were included for the purpose of study admitted in Nephrology Unit, Pt. J.N.M. Medical College Raipur from was studied. All patients were subjected to routine investigations like complete blood counts, urea, creatinine, serum bilirubin, liver enzymes, electrolytes (sodium, potassium, chloride and calcium), urine routine microscopy, 24 hour urinary protein; thyroid function test, chest X-ray and ultrasonography of abdomen. Results: A total no of patients included in study are 28. The mean age of the patient is 11±2.86 years. Out of 65% patients are male while 35% patients are female. All patients have hypoalbuminea. The mean 24 hour urine protein is 3.1±1.2 grams. 46% patients are hypothyroid; out of them 62% was male & 38% was female. 72% patients shows electrolyte imbalance. 97% patients shows abnormal usg findings in which, ascites, increased echotexture pleural effusion seen in 43.5%, 28%, 28.5% respectively. Average weight of the nephrotic syndrome patient is 28±13.69 kg. Average weight reduction in week duration is 6.78±0.78 kg; dose of deflazacort used is 1 mg/kg body weight. Dose of mycophenolate mofetil used is 12 mg/kg body weight. No patients’ shows complication related to mycophenolate mofetil. 96.4% patients’ showed improvement in 6 month follow up & only 1 patient had relapse because of irregular medication. Conclusion: Male shows greater improvement than female. Maximum weight reduction was from 69 kg to 59 kg at the time of discharge. Hypoalbuminemia and hypothyroidism was common in female than male. 96.4% patients showed improvement with deflazacort & mycophenolate mofetil. Deflazacort & mycophenolate mofetil shows better results in treatment of nephritic syndrome.