Pharmacokinetics of prednisolone in children with nephrosis

Article Abstract:

Nephrotic syndrome is a kidney disease marked by increased protein in the urine, low blood protein, and fluid retention. Treatment with steroid hormones (glucocorticoids) reduces the number of episodes in most patients. However, in some patients glucocorticoid drugs are not effective in controlling the disease. It is thought that the glucocorticoid drugs, which tend to suppress secretion of pituitary hormones, predispose patients to relapse. Unresponsive patients may have different pharmacokinetic responses to glucocorticoids than patients having a good response. Some children experience more side effects during therapy, such as a rounded face ('moon face') and decreased levels of circulating albumin. The pharmacokinetic variability of intravenously administered prednisolone was studied among 11 children with nephrotic syndrome who experienced relapse after steroid therapy, and among three patients taking steroids for a reason other than nephrotic syndrome. Since glucocorticoids tend to circulate in the blood while bound to other proteins, total bound and unbound prednisolone was measured. The clearance of bound and unbound prednisolone was lower in children experiencing a relapse of nephrotic syndrome than in the comparison group. The amount of the unbound drug in the blood corresponded to the degree of hypoalbuminemia, a reduction in the binding protein albumin circulating in the blood. On the basis of these results, it is concluded that prednisolone clearance is altered in children with relapsed nephrotic syndrome, and that the amount of circulating binding protein affects the response to steroid treatment. Reducing the dosage of prednisolone to levels compatible to the amount of circulating albumin is suggested. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Corticosteroids, Adrenocortical hormones, Dosage and administration, Nephrotic syndrome, Prednisolone

---

Anticarbamazepine antibody induced by carbamazepine in a patient with severe serum sickness

Article Abstract:

Carbamazepine is a drug that is used to prevent seizures in patients with epilepsy. The most common side effect of this drug is a skin rash that appears 7 to 10 days after treatment is begun. Under most circumstances the drug is discontinued at the first sign of a skin rash, because the rash may be an indication that the patient is allergic to the drug. During the 7- to 10-day period required for the rash to appear, the body makes antibodies that can cause an allergic reaction. This article describes the case of an eight-year-old girl with epilepsy who was being treated with carbamazepine. Ten days after she started taking this drug she developed a rash on her face that disappeared after a few days. Several days later the dose of the drug was increased and the rash reappeared and was accompanied by a fever. She was admitted to the hospital with symptoms of serum sickness that included rash, fever, swelling in the face, and abnormally large lymph glands. It was suspected that the patient was having a hypersensitivity (allergic) reaction to carbamazepine. The drug was discontinued, but the fever and rash persisted. A skin patch test was performed to determine if the patient was having an allergic reaction to the drug. When the drug was applied to a small area of the skin it caused the skin to turn red, indicating that the patient was indeed allergic. A sample of the patient's blood was found to contain antibodies against carbamazepine, and it was concluded that the antibodies caused the serum sickness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Complications and side effects, Skin, Dermatitis, Drug allergy, Drug hypersensitivity, Carbamazepine, Serum sickness

---

Similar abstracts:

• Abstracts: A randomized controlled trial of prednisone in patients with idiopathic membranous nephropathy. What have we learned about the treatment of idiopathic membranous nephropathy with steroids?
• Abstracts: Prognostic factors and life expectancy in children with AIDS and pneumocystis carinii pneumonia. Immune complexes in pediatric human immunodeficiency virus infection
• Abstracts: Nitrogen deposition in malnourished children with cystic fibrosis. Pancreatic function in infants identified as having cystic fibrosis in a neonatal screening program
• Abstracts: Measles immunization in children with clinical reactions to egg protein. Skin testing prior to measles vaccination for egg-sensitive patients
• Abstracts: Comparison of rehabilitation in patients undergoing home dialysis. Clubbing in hypersensitivity pneumonitis: its prevalence and possible prognostic role

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.