Concomitant therapy with prednisolone and cyclophosphamide in 17 cases with IgA nephropathy.

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Prednisolone and cyclophosphamide were administered to 17 patients (12 male and 5 female) with IgA nephropathy for 6-12 weeks (8 weeks on average). The results showed an improvement in urinary findings in 10 cases (9 males and 1 female), and recurrence or ineffectiveness in 7 cases (3 males and 4 females). The duration from the start of concomitant administration of both drugs to improvement in the urinary findings ranged between 1 and 36 weeks (22 weeks on average). On light microscopy, no correlation was found between the degree of changes in the renal tissues and the therapeutic effects. The fluorescent findings revealed that as a result of administration of the two drugs, improvement in urinary findings was present in 9 (75%) of 12 cases where IgA was mainly demonstrated in the stylobasal membrane of the glomerulus, but this regimen was effective in only 1 (20%) of 5 cases where IgA was observed chiefly as masses in the mesangium. Renal biopsy was performed twice, before and after the treatment, in 8 of the 17 cases. Improvement in urinary findings and disappearance of IgA in the renal glomerulus were observed in 2 cases, while IgA positive findings continued even after improvement of the urinary findings in 4 cases. The urinary findings and histologic findings were unchanged in the remaining 2 cases.
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