Cyclosporin A in combination with corticosteroids as a treatment for immunoglobulin A vasculitis nephritis in children.

Abstract

Immunoglobulin A vasculitis is the most common vasculitis in children. It is usually a self-limiting condition, and the long-term prognosis depends on the severity of renal involvement. Although cyclosporin A is not generally recommended for the management of moderate immunoglobulin A vasculitis nephritis, a few previous reports showed its efficacy. Our aim was to determine whether the treatment with cyclosporin A in combination with corticosteroids is safe and effective for moderate pediatric immunoglobulin A vasculitis nephritis. Nine children underwent treatment. Mean follow-up was 3.1±1.6 (1.4-5.8) years. All children (seven females and two males) reached complete remission (65.8±27.6 [24-99]) days. No patient had relapse, one patient had slightly impaired kidney function (glomerular filtration rate 84.4 mL/min/1.73 m2), and two patients had microscopic hematuria without proteinuria at last follow-up. One patient with delayed treatment had microscopic hematuria at last follow-up and developed early albuminuria after cessation of immunosuppression. We observed no serious complications or side effects of the treatment. Cyclosporin A in combination with corticosteroids seems to be a safe and effective treatment for moderate immunoglobulin A vasculitis nephritis. More studies with cyclosporin A should be conducted to better determine the best therapeutic approach.