[Growth retardation in children with frequent relapsing nephrotic syndrome on steroid--improvement of height velocity after administration of immunosuppressive agent].

In a study involving 22 cases of nephrotic syndrome in children, investigations were made of growth disturbance caused by corticosteroid in relation to dose of the steroid and age levels at steroid treatment and also of the effects of concomitantly used immunosuppressive drugs. The final height of frequent relapsing nephrotic syndrome was below M-2SD in approximately 30% of cases. Final heights of boys receiving the steroid from 12 to 16 years of age and of girls treated with the steroid from 10 to 14 years of age were below M-2SD and 10 cm lower than the target height. Final heights of boys and girls who could be withdrawn from steroid therapy by the age of 14 and 12, respectively, were invariably within or above the normal range. The addition of azathioprine therapy resulted in no appreciable reduction of steroid dosage nor improvement of yearly growth rate, although the frequency of relapse for that year was diminished. Under a regimen of concomitant cyclophosphamide the frequency of relapse and steroid dosage was also reduced but the growth rate was accelerated, no significant reduction of steroid consumption was achieved. The administration of cyclosporin A in doses of 1.5-5.0 mg/kg was marked by a reduction in steroid dosage as well as in the frequency of relapse and allowed for near normal growth rate, with no significant differences being observed between the high dose group (3-5 mg/kg/day) and the low dose group (1.5-2.5 mg/kg/day). Prolonged steroid therapy in frequent relapsing nephrotic syndrome may produce dwarfism and other distressing side effects.(ABSTRACT TRUNCATED AT 250 WORDS)