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April 1989

Does Methylprednisolone Pulse Therapy Deteriorate the Course of Rapidly Progressive IgA Nephropathy?

Am J Dis Child. 1989;143(4):441-442. doi:10.1001/archpedi.1989.02150160063007

Sir.—We read with interest the article by Welch et al1 in the July 1988 issue of AJDC. They reported that methylprednisolone pulse therapy (MPT) given to three of five children who had rapidly progressive IgA nephropathy did not alter the course of disease in any of the patients. We report that MPT caused deteriorated renal function in a boy with IgA nephropathy. Careful consideration should be given to the use of MPT in children with IgA nephropathy.

Patient Report.—A 12-year-old boy, previously in good health and with no family history of renal disorders, was admitted to our hospital for investigation of microscopic hematuria, proteinuria, and deteriorated renal function. Urinary abnormalities had been detected at a school screening in 1986. At that time, his serum creatinine and blood urea nitrogen levels were within the normal range. Urinary abnormalities had been again detected in 1987, and he had remained

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