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April 1989, Vol 143, No. 4 >
Article | April 1989

Does Methylprednisolone Pulse Therapy Deteriorate the Course of Rapidly Progressive IgA Nephropathy?-Reply

THOMAS R. WELCH, MD; A. JAMES McADAMS, MD; ANNETTE BERRY
Am J Dis Child. 1989;143(4):442. doi:10.1001/archpedi.1989.02150160064008.
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In Reply.—The case reported by Itami et al is consistent with our belief that MPT does not improve the course of rapidly progressive IgA nephropathy. As we stated in our article, such therapy was attempted in three of the five patients with no discernible benefit. The rationale for using the therapy in these patients had been our apparent success in using MPT for the treatment of some patients with idiopathic RPGN.1 In retrospect, it is obvious to us that this approach is of no use in rapidly progressive IgA nephropathy or in any other crescentic immune complex glomerulonephritis. Whether such therapy can actually hasten the deterioration in renal function is not clear. With a creatinine clearance of 27.5 mL/min/1.73 m2 and a biopsy specimen showing globally sclerotic glomeruli, it would seem that the renal function of the patient of Itami et al was destined to deteriorate whether or not

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