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Use of Combined Hormone and Mechlorethamine (Nitrogen Mustard) Therapy in Lipoid Nephrosis

CLARK D. WEST, M.D.
AMA Am J Dis Child. 1958;95(5):498-515. doi:10.1001/archpedi.1958.02060050502007.
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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,

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