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CLARK D. WEST, M.D.

AMA J Dis Child. 1958;95(5):498-515.

	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 effectiveness of adrenal steroids and corticotropin (ACTH) in reversing the signs and chemical abnormalities associated with lipoid nephrosis is well known. In the majority of cases in which these agents are used, diuresis, cessation of albuminuria, and return to normality of the various serum constituents are observed. On the other hand, the effect of hormone therapy is short-lived, and many cases so treated will have one or more recurrences of the disease. It is doubtful whether use of hormone only at times when marked edema is present significantly alters the natural history of the disease¹; the fatality rate for patients treated in this manner is approximately 25% to 35%.^2,3

In recent years an effort has been made to prevent recurrences by giving prolonged therapy with adrenal steroid or corticotropin while the disease is in remission. The patient is given small doses of hormone, usually steroid, daily, or, . . . [Full Text PDF of this Article]

Author Affiliations
Cincinnati

From the Children's Hospital Research Foundation (Fellow) and the Department of Pediatrics, University of Cincinnati College of Medicine (Associate Professor of Pediatrics).

Footnotes
Received for publication Nov. 25, 1957.

This investigation was supported in part by a research grant (H-1638) from the National Heart Institute, United States Public Health Service.

The term "pure" lipoid nephrosis has been used to denote a disease characterized by the changes typical of the nephrotic syndrome which is capable of remission with return to normality of the serum constituents, cessation of albuminuria, and loss of edema. The remission may be spontaneous or induced by hormone therapy, of brief or of long duration. The patients reported in detail in this paper all demonstrated, when first studied, the ability to have remissions. A few had hypertension and elevation of the concentration of blood urea nitrogen either before or during hormone therapy. These abnormalities have not excluded them from the category of pure nephrosis. The results of a limited experience with combined hormone-mechlorethamine therapy in patients with "chronic" nephrosis, characterized by disease of long standing in which albuminuria is always present and unresponsive to hormone therapy, are also briefly discussed.

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