Clinical Profile &Treatment Outcome in Children with IgM Nephropathy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 1
Abstract
Introduction: IgM Nephropathy (IgMN) is a relatively new clinico-immunopathologic entity which presents as idiopathic nephrotic syndrome (NS) in children. Paediatric IgMN has a wide clinico-histopathological spectrum with ill-defined treatment options. Nephrologists often face a challenge in diagnosing and deciding the best treatment plan for these children. Methodology: This retrospective study was conducted from January 2010-December 2014 to analyze the clinical spectrum and treatment responses of IgMN in our tertiary centre in Eastern India. All children aged 6 months-14 years with biopsy proven IgMN were included in this study. Definitions and treatment protocols were followed as per Indian Society of Pediatric Nephrology (ISPN) guidelines. Their demographic data, laboratory features and treatment outcomes were documented and analyzed. Results: Twenty children with biopsy proven IgMN were considered in this study. Indications of renal biopsy were steroid dependence in 13(65%) cases, steroid resistance in 6(30%) cases and one child was presented with infantile NS. Except infantile NS child, 19 cases received Prednisolone before other drugs. Later, Cyclosporine A was given in 8(40%) cases, cyclophosphamide in 3(15%), Tacrolimus in 4(20%) & Mycophenolate moefetil in 5(25%) children. At one year of follow up, 18(90%) cases had complete remission and two had partial remission. Conclusion: IgMN presents commonly as SDNS & these patients respond excellently to non-steroidal immunosuppressants but we need longer follow-up to understand this entity more properly.
Authors and Affiliations
Pawan Mutalik, Subal Kumar Pradhan, Saroj Kumar Satapathy
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