Cyclosporine A Effect on Hearing in Children with Steroid Dependent Nephrotic Syndrome and Steroid Resistant Nephrotic Syndrome.

Abstract

Introduction: Cyclosporine A (CsA) plays a confounding role in the treatment of nephrotic syndrome (NS) in children. It is a widely used in pediatric nephrology practice for the treatment of patients with steroid dependent nephrotic syndrome (SDNS) and steroid resistant nephrotic syndrome (SRNS). Aim of the study: To assess hearing defects in children with steroid dependent nephrotic syndrome (SDNS) and steroid resistant nephrotic syndrome (SRNS), before and after receiving CsA for 6 months. Methods: Prospective observational study was conducted on 25 pediatric patients with SDNS and SRNS in pediatric nephrology clinic, Children's hospital, Ain Shams University, were trialed to evaluate hearing defects before and after receiving CsA for 6 months. Patients were subjected to history taking and basic audiological evaluation before and 6 months after initiation of CsA treatment. Results: Valid cases showed that the average mean hearing threshold shows non-significant changes before and after six months of cyclosporine A treatment with (p= 0.954) at 250 Hz, (p= 0.868) at 500 Hz, (p= 0.473) at 1000 Hz, (p= 0.680) at 2000 Hz, (p= 0.535) at 4000 Hz and (p= 0.865) at 8000 Hz respectively. There was no correlation between age, weight, height, age at first clinical presentation, duration of corticosteroid intake, regarding average of hearing before and after six months of cyclosporine A treatment. Concerning speech and language evaluation, all patients had bilateral excellent speech discrimination before and after CsA treatment. Immitancemetry showed bilateral type A tympanogram reflecting normal middle ear pressure in all patients before and after CsA treatment. Conclusion:CsA cause no hearing impairment effect on patients with SDNS and SRNS after 6 months of administration. We may suggest that there is no sufficient evidence to consider routine audiological assessment in children with SDNS and SRNS treated with CsA.

Hearing Loss Due to Cyclosporine In Children

“…12 One prospective observational study done by El-Farsy MS et al checked for the effect of cyclosporine on hearing in children with steroid-resistant and steroiddependent nephrotic syndrome. 13 It is observed that there was no eect on hearing on the follow-up to 6 months. However, our patient took cyclosporine for 4 years and had a hearing issue since the first year of cyclosporine use.…”