Idiopathic membranous glomerulopathy in Canadian children: A clinicopathologic study

Latham, Patricia S.; Poucell, S; Koresaar, A.; Arbus, Gerald S.; Baumal, Reuben

doi:10.1016/s0022-3476(82)80290-4

Cited by 35 publications

(20 citation statements)

References 9 publications

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“…Moreover, the final outcome was complete remission in 75% overall-including 70% of patients presenting with NS or nephrotic range proteinuria. These results appear to be better than those from other pediatric studies from North America where remission rates are <50% and chronic renal disease has been reported in 21-33% of cases (Table 5) [13][14][15]29]. The reason(s) for the better clinical outcomes of the children in our study relative to other North American studies are unknown.…”

Section: Discussioncontrasting

confidence: 67%

Membranous glomerulonephritis: treatment response and outcome in children

et al. 2009

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The aim of this study was to characterize clinical features, treatment response, and outcome of idiopathic membranous glomerulonephritis (MGN) in a single-center cohort of children. A retrospective review of biopsy-proven idiopathic MGN in 12 children (mean age 11.9 years) was undertaken. Presentation was nephrotic syndrome (NS) (75%), hematuria/proteinuria (17%), and asymptomatic proteinuria (8%). Ten patients (83%) with NS and nephrotic range proteinuria (NRP) were treated with prednisone, and two patients with non-NRP were not treated with immunosuppressive medications. Steroid response in the treated patients was complete (10%), partial (40%), and absent (50%), respectively. Oral cyclophosphamide was used in seven patients of whom five were steroid resistant, one was steroid dependent, and one was partially responsive. At the mean follow up of 27 months, outcome parameters included an estimated glomerular filtration rate of 128 cc/min per 1.73 m(2), albumin of 4.2 gm/dL, and a urine protein/creatinine ratio of 0.87 [median 0.16 (range 0.02-6.52)]. Remission was complete in 75% of the patients and partial in 17%. One patient (8%) with chronic kidney disease (stage 2) was unresponsive to therapy. Complete remission was significantly associated with the absence of chronic histological changes (p = 0.03). In conclusion, children with NS and/or NRP associated with MGN appear to have a good prognosis when treated with a combination of corticosteroids and cyclophosphamide.

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Section: Discussioncontrasting

confidence: 67%

Membranous glomerulonephritis: treatment response and outcome in children

et al. 2009

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“…All 11 children received oral prednisolone (60 mg/m 2 /day) daily (NS 2-11) or every other day (NS 1); three on daily prednisolone (NS 2,3,4) were steroid responders and became free of proteinuria at 6, 16, 2 months after therapy, respectively, and did not experience a relapse (Figs. 4,5).…”

Section: Pathologic Findingsmentioning

confidence: 99%

“…MN is a common cause of nephrotic syndrome (NS) in adults, but this occurs infrequently in children [2][3][4][5][6][7]. Idiopathic MN, a form of MN without any associated systemic diseases used to be uncommon in Korean children in whom hepatitis B virus (HBV) infection was endemic and HBV-associated MN (HBV-MN) was the major cause of childhood MN [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…In adults, several controlled studies [12][13][14][15][16][17] have recommended that immunosuppressive agents be administered to patients with NS or persistent nephrotic range proteinuria, although debate remains over the efficacy of the immunosuppressive treatment [18][19][20]. Moreover in children, the efficacies of immunosuppressive medications have not yet been verified [2][3][4][5][6][7]21].…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic membranous nephropathy in children

et al. 2006

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Idiopathic membranous nephropathy (MN) is a rare cause of asymptomatic proteinuria (AP) or nephrotic syndrome (NS) in childhood. To improve our understanding of its clinical course, we retrospectively reviewed 19 cases of idiopathic MN seen in our hospital over a period of 28.5 years, i.e., from January 1977 to July 2005. Eight patients (39%) had AP and 11 (61%) presented with NS. All eight AP patients achieved remission, regardless of treatment modality. Oral corticosteroid was given to all 11 NS patients, but only three of them responded to corticosteroid. Of the eight steroid non-responders, three achieved remissions with the addition of cyclosporine, and the five who were not administered additional immunosuppressive drugs had persistent NS. At the latest evaluation, all six NS patients that achieved remission remained free of proteinuria and had a normal renal function. Moreover, two of the 5 steroid non-responders showed persistent nephrotic-range proteinuria but a stable renal function. The remaining three steroid non-responders progressed into chronic renal insufficiency, and this progression was preceded by renal vein thrombosis (RVT) in two of the three patients. Presentation with NS (P=0.045) and the development of RVT (P=0.010) were identified as poor prognostic factors.

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“…They added 10 personal cases and 15 others in a paper in 1982 [15]. In children however, membranous nephropathy associated with malignant turnout is rare; no such association was noted in the 85 cases of membranous nephropathy collected by Kleinknecht et al, [10], nor in the 14 [11] and 22 [20] cases more recently reported. The problem of membranous nephropathy in Wilms tumour [4] is usually different, with lesions of mesangial sclerosis; only one case of membranous nephropathy was reported [21].…”

Section: Discussionmentioning

confidence: 99%