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Article |

High-Dose Corticosteroids Their Use in Treating Idiopathic Rapidly Progressive Glomerulonephritis

William M. O'Neill Jr, MD; Whitson B. Etheridge, MD; H. Allan Bloomer, MD
Arch Intern Med. 1979;139(5):514-518. doi:10.1001/archinte.1979.03630420010007.
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To evaluate the response of patients with idiopathic rapidly progressive glomerulonephritis (RPGN) to high-dose corticosteroids, we have studied ten consecutive patients with this disorder. All were given 1 g of methylprednisolone intravenously each day for one week and then placed on a high-dose orally administered prednisone regimen. Four of the ten patients with idiopathic RPGN responded with a sustained reduction in the serum creatinine level of at least 50%. The patients who responded were characterized by a symptomatic illness of short duration and normal blood pressure. Renal biopsies in the responding patients showed minimal glomerular and crescentic sclerosis with mild interstitial fibrosis. The nonresponders had a long symptomatic illness with elevated initial blood pressures. The renal tissue in this group had considerable fibrosis of the crescents, glomeruli, and interstitium. The results suggest that a certain group of patients with idiopathic RPGN will improve with high-dose corticosteroid therapy.

(Arch Intern Med 139:514-518, 1979)


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