According to a new study, children who use steroid drugs for nephrotic syndrome do not suffer from osteoporosis, which is a common side effect of steroid treatment methods in adults.

Childhood nephrotic syndrome, which is thought to affect 3 out of 100,000 children, is one of the most common chronic kidney diseases in children. Although it does not impair kidney function, it weakens ability of the body to remove salt and water in the blood causes swelling of the legs and stomach and around the eyes.

From News-Medical.Net:

“Unlike other childhood diseases treated with steroid drugs, such as inflammatory bowel disease or juvenile rheumatoid arthritis, nephrotic syndrome resolves quickly when treated,” said pediatric nephrologist Mary B. Leonard, M.D., of The Children’s Hospital of Philadelphia, lead author of the study. “We specifically chose steroid-sensitive nephrotic syndrome because we are able to isolate the drug’s effects on bones, without having an underlying systemic disease simultaneously affecting the bones.”

The team led by Dr. Leonard compared 60 children and adolescents with steroid-sensitive nephrotic syndrome to 195 healthy children. Specialized X- ray measurements showed no signs of osteoporosis, a loss in bone mass, among the nephrotic syndrome patients. The study appeared in the August 26 New England Journal of Medicine.

The researchers made adjustments for body mass index, an important consideration, since 38 percent of the children in the nephrotic syndrome sample were obese (in contrast, only 16 percent of the control subjects were obese, a proportion consistent with the general pediatric population). The disproportionate obesity among children with nephrotic syndrome disappears after the patients discontinue steroid treatments.

“While steroids tend to make children shorter and heavier than healthy children, increased weight is associated with an increase in bone mass,” said co-author Babette Zemel, Ph.D., of the Nutrition Center at Children’s Hospital. Specifically, whole-body measurements of bone mineral content were higher in children with nephrotic syndrome than in healthy children.

Dr. Leonard said that the findings of this report may be used to assure parents and doctors about steroid treatments too help children with nephrotic syndrome that steroids do not increase their risk of osteoporosis.

Tags: childhood nephrotic syndrome, Nephrotic syndrome, Steroid drugs, steroid treatment, steroids

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In a study with 129 patients, initial treatment with infliximab plus azathioprine in patients with moderate to severe Crohn’s disease leads to more remissions when compared to a standard approach starting with topical or systemic steroid treatment.

Geert D’Haens, M.D., said at the 13th United European Gastroenterology Week, “Steroids are not necessary for treating Crohn’s disease.”

From Internalmedicinenews.com:

The study’s primary end point was the remission rate at 6 and 12 months after starting treatment. Remission was defined as having a Crohn’s disease activity index of less than 150, with no ongoing need for steroid treatment and no surgical resection. After 6 months, the remission rate was 60% in the infliximab-first group and 41% in patients who received steroids first, a statistically significant difference. After 12 months, the remission rate was 61% in the infliximab-first patients and 50% in those given steroids first, a nonsignificant difference.

Of the infliximab-first patients, 59% required no additional infliximab beyond their initial three doses during the year of follow-up. In the steroid-first group, 62% of patients also required treatment with azathioprine.

The study also used a new measure of efficacy, the rate of overall treatment success. This measure tracked the number of patients who reached and maintained a remission after 14, 26, 39, and 52 weeks of treatment. This end point was reached by 29% of patients in the infliximab-first group and 5% of those treated with a steroid first, a statistically significant difference.

The study was sponsored by Centocor and Schering-Plough.

Tags: azathioprine, infliximab, steroid treatment, steroids

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According to a study appearing in an issue of the Journal of the American Society of Nephrology (JASN), patients with IgA nephropathy can benefit from use of steroids. It was revealed by the study that individuals suffering from the kidney disease can prevent or delay loss of kidney function with steroids.

The list of study co-authors included Simeone Andrulli, Lucia Del Vecchio, Francesco Locatelli (Ospedale di Lecco), Antonello Pani (Ospedale di Cagliari), Patrizia Scaini (Ospedale di Brescia), Giambattista Fogazzi (Ospedale Maggiore di Milano), Bruno Vogt (Inselspital di Berna), Vincenzo De Cristofaro (Ospedale di Sondrio), Landino Allegri (Ospedale di Parma), Lino Cirami (Ospedale di Firenze), and Aldo Deni Procaccini (Ospedale di Foggia).

From Sciencedaily.com:

“Our study shows that corticosteroids are very useful in patients with IgA nephropathy, and that the addition of an immunosuppressant drug, such as azathioprine, doesn’t increase their benefit,” comments Claudio Pozzi, MD (Ospedale E. Bassini, Milan).

Patients with IgA nephropathy develop deposits of the protein IgA in the kidneys. The abnormal IgA deposits damage the glomeruli (the filtering units of the kidney), leading to blood and protein in the urine. Previous studies have shown that steroids can reduce urine protein levels and help protect kidney function. However, some patients develop progressive kidney disease, despite steroid treatment.

The kidney complication is an autoimmune disease, which is regarded as a major cause of end-stage failure of the kidneys in younger people.

Tags: azathioprine, steroid treatment, steroids, use of steroids

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According to a finding published as part of a study in an issue of the Journal of the American Society of Nephrology (JASN), treatment with steroids can prove to be a beneficial option for delaying or preventing loss of kidney function in patients with IgA nephropathy, a type of kidney disease.

The kidney complication is an autoimmune disease affecting the kidneys and is considered as a major cause of end-stage failure of the kidneys in younger people.

From Sciencedaily.com:

“Our study shows that corticosteroids are very useful in patients with IgA nephropathy, and that the addition of an immunosuppressant drug, such as azathioprine, doesn’t increase their benefit,” comments Claudio Pozzi, MD (Ospedale E. Bassini, Milan).

Patients with IgA nephropathy develop deposits of the protein IgA in the kidneys. The abnormal IgA deposits damage the glomeruli (the filtering units of the kidney), leading to blood and protein in the urine. Previous studies have shown that steroids can reduce urine protein levels and help protect kidney function. However, some patients develop progressive kidney disease, despite steroid treatment.

The list of study co-authors included Simeone Andrulli, Lucia Del Vecchio, Francesco Locatelli (Ospedale di Lecco), Antonello Pani (Ospedale di Cagliari), Patrizia Scaini (Ospedale di Brescia), Giambattista Fogazzi (Ospedale Maggiore di Milano), Bruno Vogt (Inselspital di Berna), Vincenzo De Cristofaro (Ospedale di Sondrio), Landino Allegri (Ospedale di Parma), Lino Cirami (Ospedale di Firenze), and Aldo Deni Procaccini (Ospedale di Foggia).

Tags: azathioprine, steroid treatment, steroids

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Treatment with steroids could lead to prevention or delay loss of kidney function in patients with IgA nephropathy, a type of kidney disease. This finding will be disclosed by a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

This kidney complication is an autoimmune disease that affects the kidneys and regarded as a major cause of end-stage failure of the kidneys in younger people.

From Sciencedaily.com:

“Our study shows that corticosteroids are very useful in patients with IgA nephropathy, and that the addition of an immunosuppressant drug, such as azathioprine, doesn’t increase their benefit,” comments Claudio Pozzi, MD (Ospedale E. Bassini, Milan).

Patients with IgA nephropathy develop deposits of the protein IgA in the kidneys. The abnormal IgA deposits damage the glomeruli (the filtering units of the kidney), leading to blood and protein in the urine. Previous studies have shown that steroids can reduce urine protein levels and help protect kidney function. However, some patients develop progressive kidney disease, despite steroid treatment.

The list of study co-authors included Simeone Andrulli, Lucia Del Vecchio, Francesco Locatelli (Ospedale di Lecco), Antonello Pani (Ospedale di Cagliari), Patrizia Scaini (Ospedale di Brescia), Giambattista Fogazzi (Ospedale Maggiore di Milano), Bruno Vogt (Inselspital di Berna), Vincenzo De Cristofaro (Ospedale di Sondrio), Landino Allegri (Ospedale di Parma), Lino Cirami (Ospedale di Firenze), and Aldo Deni Procaccini (Ospedale di Foggia).

Tags: azathioprine, steroid treatment, steroids

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Pediatric oncologists at the Brenner Children’s Hospital, a part of the Wake Forest University BaptistMedical Center , have disclosed that young children suffering from chicken pox and treated with steroids could be at a risk for a more severe virus incidence that may lead to death.

This finding is expected to act as a warning bell for medical practitioners who have been treating their young patients afflicted with chicken pox with steroids.

From News-Medical.Net:

“Steroids are used to treat leukemia and they suppress the immune system,” said Thomas McLean, a pediatric oncologist at Brenner Children’s Hospital. “When a child is exposed to the varicella virus (the virus that causes chicken pox) around the time they are receiving steroid treatment, they are more likely to contract a more severe case of chicken pox.”

McLean and his colleagues studied 697 patients with acute leukemia over a nine-year period. About 16 percent or 110 patients contracted chicken pox. Of those 110 patients, 54 had severe disease, including two deaths. Of the patients whose chicken pox was diagnosed within three weeks of taking steroids, 70 percent had severe infection whereas only 44 percent of those who had not received steroid therapy within three weeks had severe infection. Although the study was limited to patients with leukemia, the findings may apply to other conditions for which steroids are used, McLean said.

“One of the things we need to remember to ask before we prescribe steroid treatment is whether the child has had a recent exposure to chicken pox,” McLean said. “If so, we recommend waiting until the incubation period has passed before beginning steroid therapy.”

Chicken Pox, though mild in its nature, could be devastating in some cases. It is worthwhile to note here that as many as 12,000 people used to die because of this disease every year before the varicella vaccine was discovered.

Tags: chicken pox, steroid therapy, steroid treatment, steroids

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R-roscovitine, a drug that is presently being tested for cancer, may prove for treating asthma as well, according to a research.

The drug can prove effective for killing certain immune cells capable of exacerbating symptoms associated with asthma, as per scientists at the University of Edinburgh.

From Sciencedaily.com:

Eosinophils, found in the lungs and airways, help the body fight off parasitic infection. However, too many uncontrolled eosinophils can damage other cells that line the lung, contributing to inflammatory conditions such as asthma.

Researchers found that use of the drug caused the eosinophil cells to undergo a form of cell death known as apoptosis, a natural process where unwanted cells are removed from the body.

Professor Adriano Rossi, of the Centre for Inflammation Research at the University of Edinburgh who directed the study, said: “Steroids are commonly used to treat asthma but can have unwanted side-effects, while some asthma patients are also resistant to steroid treatment. It may well be that use of a drug, such as R-Roscovitine, or one that works in a similar same way, could offer an alternative to steroids, or be used in conjunction with steroid treatment for asthma patients.”

The finding is expected to offer an alternative way for treating asthma in patients who show resistance to steroids that are commonly used and prescribed in asthma treatments.

Tags: apoptosis, Asthma, cancer, steroid treatment, steroids

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Recessive mutations in a gene called phospholipase C epsilon or PLCE1 can lead to a severe, early-onset form of kidney disease and renal failure in children, a previously unknown cause. This finding was revealed by scientists at the University of Michigan Medical School.

The mutant gene identification is important for the scientists since PLCE1 affects the development of podocytes, which are specialized cells playing a vital role in the kidney’s ability to remove waste products from blood and retaining important blood proteins.

From Sciencedaily.com:

Some types of nephrotic syndrome can be treated with steroids or other drugs, but steroid-resistant forms of the disease as a rule do not respond to treatment. Untreated nephrotic syndrome often causes severe scarring and a condition called focal segmental glomerulosclerosis (FSGS), which progresses about 50 percent of the time to end-stage kidney disease and renal failure.

PLCE1 is the seventh gene scientists have found to be involved in different types of steroid-resistant nephrotic syndrome, and the second gene that is expressed in podocytes — specialized cells with octopus-like tentacles surrounding the glomerulus.

Podocytes are currently under intensive study, because scientists believe they play a vital role in the blood filtration process. Identifying genes and proteins that are active in podocytes will help scientists understand how they work.

“We found that PLCE1 is expressed in developing and mature podocytes,” says Hildebrandt. “Most of the PLCE1 mutations we identified apparently prevented podocytes from developing normally in the embryo, so defects were present at birth. A milder mutation seemed to interfere with repair mechanisms in the glomerulus, so defects didn’t show up until later in life.”

Friedhelm Hildebrandt, M.D., the U-M’s Frederick G L Huetwell Professor for the Cure and Prevention of Birth Defects, said this is the first report of infants with two mutations in a recessive gene for nephrotic syndrome (resistant to steroid treatment) that nevertheless responded to treatment with steroids.

Tags: kidney disease, mutant gene, steroid, steroid treatment, steroids

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The risks of reintubation and stridor can be reduced to a significant extent in high-risk patients with administration of steroids at least four hours before extubation, as per a report.

Dr. Samir Jaber from University of Montpellier I in France and colleagues conducted a quantitative meta-analysis of seven studies and find out the efficacy of prophylactic steroid therapy to prevent reintubation and post-extubation stridor.

From Medscape.com:

Administration of steroids at least 4 hours before planned extubation significantly reduced the risk for reintubation, but not for stridor, the researchers note, and later administration of steroids did not decrease the risk for reintubation or stridor.

The investigators conclude: “The present meta-analysis suggests, first that the beneficial effect of steroids to prevent post-extubation stridor and reintubation were observed in the subgroup of patients with a high risk to develop post-extubation stridor, as identified by the cuff-leak test, and second that steroid treatment before a planned extubation decreases the risk of reintubation only if intravenous steroid administration was performed at least 4 hours before planned extubation.”

“The benefit of steroid remains unclear when patients are not selected,” they conclude.

It was suggested by the study that steroid treatment is beneficial for reducing the risk of reintubation in trials that enrolled high-risk patients.

Tags: extubation, prophylactic steroid therapy, reintubation, steroid treatment, steroids, stridor

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Steroids, when added to the standard form of treatment, are effective in considerably reducing the odds of developing heart damage in children with Kawasaki‘s disease.

This finding was disclosed by a study in an issue of Pediatrics and highlights a gap in knowledge. The study emphasized on benefits of steroid treatment for Kawasaki’s disease and is expected to provide insights to members of the medical fraternity in treating this health concern in an effective manner.

From News-Medical.Net:

Current guidelines from the American Academy of Pediatrics state that the evidence for steroid treatment is lacking and recommend the standard treatment for Kawasaki’s, which is aspirin and intravenous immunoglobulin (IVIG).

“This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki‘s disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half,” said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

Kawasaki‘s disease is one of the leading causes of acquired heart disease in children with an unknown cause. The symptoms of this complication are red eyes, palms and foot soles, and swollen lymph nodes.

Tags: Kawasaki's disease, steroid treatment, steroids

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