CONTINUOUS THERAPY OF NEPHROTIC SYNDROME IN CHILDREN WITH CORTICOTROPIN GEL

Abstract

INTERMITTENT treatment with adrenocorticotropic hormone, first described by Farnsworth,¹is a definite milestone in the management of the nephrotic syndrome. Diuresis is accomplished in 45 to 80% of the cases,* and in many improvement is maintained. Those who require repeated courses, however, swing from an edematous state to a dehydrated, washed-out, debilitated condition and are rarely well enough to live normal lives. They eat voraciously at times and are anorectic at others. In the summer of 1951, when a 3-year-old child failed to have her usual diuretic response following a 12-day course of corticotropin (ACTH) treatment was resumed at a lower dosage level for two more weeks, after which complete diuresis occurred. The child (L. H.) had had a series of 10 courses by March 3, 1952. Between courses albuminuria would disappear, only to reappear in a few days followed by edema. She was never well enough to permit