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Alkylating and Antimetabolic Agents in the Treatment of Nephrotic Syndrome, Lupus Nephritis, Chronic Glomerulonephritis, and Purpura Nephritis in Children

WARREN E. GRUPE, MD; WALTER HEYMANN, MD

Am J Dis Child. 1966;112(5):448-458.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THE USE of cytotoxic agents in the treatment of renal diseases was first reported in 1949 by Chasis^1,2 using nitrogen mustard (mechlorethamine) in adults with chronic glomerulonephritis. Shortly thereafter, Kelley and Panos³ confirmed improvement in children with nephrosis, and Taylor⁴ in adults with chronic glomerulonephritis, using the same approach. These reports were followed by others,^5-9 but as the therapeutic value of steroids became more widely accepted, cytotoxic drugs were displaced as therapeutic agents. Interest was renewed in 1963 by Coldbeck,¹⁰ Kellum and Haserick,¹¹ and Goodman and Wolff.¹² There has been further encouragement in the use of these agents in the treatment of other nonneoplastic diseases^12-15 as well as in renal diseases.^15-22

This report will review 3 years' experience in 25 children with cytotoxic drugs in addition to corticosteroids in the treatment of chronic renal diseases.

Patients and Methods

The agents used . . . [Full Text PDF of this Article]

Author Affiliations
CLEVELAND

From the Department of Pediatrics, Western Reserve University School of Medicine, Cleveland.

Footnotes
Received for publication March 23, 1966.

Reprint requests to Babies and Childrens Hospital, 2103 Adelbert Rd, Cleveland 44106 (Dr. Grupe).

Idiopathic nephrosis as used in this discussion is limited to massive proteinuria, hyperlipemia, and hypoalbuminemia occurring in the absence of persistent azotemia, hypertension, or decreased renal function and not in association with any recognized inciting agent or preexisting systemic disease. It is considered an entity distinct from the nephrotic syndrome occurring in the course of other renal diseases such as acute or chronic glomerulonephritis or renal vein thrombosis, due to chemical agents, or in association with systemic diseases such as collagen diseases, amyloidosis, or diabetes.

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