Failure of Doxantrazole in Steroid-Sensitive Nephrotic Syndrome

Bluett, N H; Chantler, C; Hughes, David J.

doi:10.1016/s0140-6736(77)93001-x

Cited by 8 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the other controlled study12 of the use of cromoglycate in patients with nephrotic syndrome, the 5 patients receiving cromoglycate had a combined total of 33 weeks in remission, whereas the 5 patients in the control group had 40 weeks in remission. Trials with other mast cell–stabilizing drugs (nivimedone and doxantrazole) also have failed to show a beneficial effect on prolonging remission in patients with relapsing nephrotic syndrome 12,55…”

Section: Inhaled Allergens and Nephrotic Syndromementioning

confidence: 99%

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Abdel-Hafez

Shimada

Lee

et al. 2009

American Journal of Kidney Diseases

116

108

View full text Add to dashboard Cite

Numerous reports during the last 60 years have reported a strong association between idiopathic nephrotic syndrome and atopic disorders. Idiopathic nephrotic syndrome can be precipitated by allergic reactions and has been associated with both aeroallergens (pollens, mold, and dust) and food allergies. Patients with idiopathic nephrotic syndrome also may show increased serum immunoglobulin E (IgE) levels. A review of the literature suggests that although some idiopathic nephrotic syndrome cases may be associated with allergies, evidence that it is a type of allergic disorder or can be induced by a specific allergen is weak. Rather, it is likely that the proteinuria and increased IgE levels in patients with idiopathic nephrotic syndrome are caused by increased levels of interleukin 13 observed in these patients. Recent studies suggest that interleukin 13, a known stimulator of IgE response, may mediate proteinuria in patients with minimal change disease because of its ability to directly induce CD80 expression on the podocyte. KeywordsAtopy; nephrotic syndrome; minimal change disease Idiopathic nephrotic syndrome in children is a clinical syndrome associated with a variety of glomerular lesions. Minimal change disease (MCD) is the most common cause of idiopathic nephrotic syndrome. MCD is often abrupt in onset. It can be dramatic in presentation, yet is one of the most rewarding diseases for a physician to manage because response to corticosteroids often is rapid and complete. Because kidney biopsy usually is not performed when the disease responds to corticosteroid therapy, the term MCD has become synonymous with steroid-sensitive nephrotic syndrome. The mechanism(s) underlying the MCD pathogenesis are unknown, although it is believed to be immunologically mediated. 1 Strong evidence suggests that it may be caused by a circulating factor, possibly T-cell related, that causes podocyte dysfunction resulting in massive proteinuria. 2 However, there also have been numerous reports linking MCD with atopic disorders and increases in serum immunoglobulin E (IgE) levels. In this review, we discuss the evidence supporting the association of atopy and whether there may be a common underlying immune disorder that may predispose patients to both conditions. ATOPYAtopy is a term used to describe IgE-mediated diseases. Persons with atopy have a hereditary predisposition to produce IgE antibodies to common allergens and often manifest with 1 or more atopic diseases (asthma, allergic rhinitis, and atopic eczema). Atopic patients mount an exaggerated immunologic response characterized by production of allergen-specific IgE antibodies and positive reactions to extracts of common aeroallergens on skin-prick tests. Type 2 helper T cells (T H 2) from patients with atopy respond to allergens in vitro by expressing such cytokines as interleukin 4 (IL-4) and IL-13 3 (Fig 1A and B). Early Reports of Atopy With MCDIn 1951, Fanconi et al 4 were among of the first to associate atopy and nephrotic syndrome. Forty-three percent of th...

show abstract

Section: Inhaled Allergens and Nephrotic Syndromementioning

confidence: 99%

Idiopathic Nephrotic Syndrome and Atopy: Is There a Common Link?

Abdel-Hafez

Shimada

Lee

et al. 2009

American Journal of Kidney Diseases

116

108

View full text Add to dashboard Cite

show abstract

“…Reservations should also be made for intervention studies that aim at the value of dietary interventions or anti-allergic regimens in the treatment of NS. Some investigators have shown that oligoantigenic diets, in addition to immunosuppressive therapy, contributed to achieve remission in some patients [103,113]; however, others found no effect of anti-allergic regimens on NS [114,115]. Here, the conflicting results may be explained by the large heterogeneity of the disease, its various responses to treatment with corticosteroids and uncertainty as to its natural course.…”

Section: Association Of Ns With Atopymentioning

confidence: 99%

Role of the immune system in the pathogenesis of idiopathic nephrotic syndrome

2004

View full text Add to dashboard Cite

Idiopathic NS (nephrotic syndrome) is characterized by massive proteinuria, due to a leak in the glomerular barrier to proteins. Genetic defects that affect the function and the composition of the glomerular capillary wall, in particular of the visceral epithelial cells, have recently been recognized as the cause of familial forms of NS. MCNS (minimal change NS) and FSGS (focal and segmental glomerulosclerosis) are common non-familial forms of NS in which the causative defect has not yet been identified. Several studies have shown that non-familial NS is associated with the presence of circulating permeability factors and with complex disturbances in the immune system. Thus far, there is no direct evidence that these factors directly alter glomerular permeability to proteins, and some of these factors may be a consequence, rather than a cause, of NS. In this review, we will briefly highlight the mechanisms that underlie proteinuria in general and focus on the immunological disturbances associated with idiopathic NS, with attention to potential mechanisms whereby the immune system may directly act on the glomerular capillary filter.

show abstract

“…The absorption of an orally administered dose amounts to 1 %, half of which appears in the urine (Walker et al, 1971) DSCG acts by inhibiting the degranulation of mast cells, thus blocking the release of biochemical mediators such as histamine and slow reacting substance of anaphylaxis. Higher doses of DSCG or absorbable analogues might be effective, but patients in relapse with SRNS did not respond to doxantrazole (Bluett et al, 1977). Summary A controlled trial of disodium cromoglycate treatment of steroid-responsive nephrotic syndrome failed to show a therapeutic effect on the tendency to relapse after withdrawal of corticosteroids.…”

Section: Discussionmentioning

confidence: 99%