Clinical Studies in the Use of BCG and Levamisole in the Treatment of Glomerulonephritis

Abstract

Sixty patients with primary glomerulonephritis and nephrotic range proteinuria (most resistant to corticosteroid therapy) were given killed BCG inoculations as a major part of combined therapy with levamisole, 3 of every 7 days, and corticosteroids in 53 patients. Following treatment 80% of patients showed complete or partial remission of proteinuria with significant improvement in urinary protein excretion, serum albumin, blood urea, and serum creatinine. Thirteen of 15 patients followed up for 1-2 years and more had complete remission at the latest review, as did five of six patients followed for less than 1 year. The longer the course of the combined immunostimulant treatment, the lower the recurrence rate. The beneficial effects of retreatment in recurrent cases were much more rapid in onset than on initial treatment. The phagocytic function of monocytes was examined in a separate group of 24 patients with primary glomerulonephritis. Function was found to be significantly depressed but could be returned to normal following BCG inoculation. Associated with the improved monocyte phagocytic function there was a significant decrease in urinary protein excretion.