Impact of periodontal treatment in combination with tonsillectomy plus methylprednisolone pulse therapy and angiotensin blockade for pediatric IgA nephropathy.

Inoue CN, Matsutani S, Ishidoya M, Homma R, Chiba Y, Nagasaka T.Source

Department of Pediatrics, Department of Otolaryngology, and Department of Dentistry, Red Cross Sendai Hospital, Sendai, Japan.

Abstract

Background: We previously reported the efficacy of extensive eradication of infectious foci in oral and ENT lesions, combined with tonsillectomy plus methylprednisolone (MP) pulse therapy, for curing pediatric Henoch-Schönlein purpura (HSP) and HSP nephritis. In the present study, we used this therapy in patients with pediatric IgA nephropathy (IgAN) to assess whether similar results could be obtained. Patients and methods: In 11 pediatric patients newly diagnosed with IgAN, exploration for infectious foci showed severe oral infection, including dental caries and apical periodontitis, in many. The overall decayed, missing and filled teeth score was elevated to 5.91. Two patients had rhinosinusitis. After extensive treatment of infectious foci, patients underwent tonsillectomy plus MP pulse therapy with angiotensin II receptor blockade. Results: Clinical remission was achieved in all patients with pediatric IgAN (various histologic grades). Remission was achieved by 7.2 ± 5.7 months after initiation of steroid therapy, and disappearance of proteinuria by 3.3 ± 3.0 months. The mean duration of oral steroid administration was 9.5 ± 3.6 months. No relapse has occurred during follow-up of 4.3 ± 2.4 y. Conclusions: Careful examination and thorough elimination of infectious foci in oral and ENT lesions can optimize the effect of tonsillectomy plus MP pulse therapy, promoting recovery from IgAN.

PMID: 22257544 [PubMed - in process] LinkOut - more resourcesFull Text SourcesDustri-Verlag Dr. Karl Feistle GmbH & Co. KGEBSCO Supplemental Content Related citations Periodontal and ENT therapy in the treatment of pediatric Henoch-Schönlein purpura and IgA nephropathy. [Adv Otorhinolaryngol. 2011] Periodontal and ENT therapy in the treatment of pediatric Henoch-Schönlein purpura and IgA nephropathy.Inoue CN, Matsutani S, Ishidoya M, Homma R, Chiba Y, Nagasaka T. Adv Otorhinolaryngol. 2011; 72:53-6. Epub 2011 Aug 18. Efficacy of early dental and ENT therapy in preventing nephropathy in pediatric Henoch-Schönlein purpura. [Clin Rheumatol. 2008] Efficacy of early dental and ENT therapy in preventing nephropathy in pediatric Henoch-Schönlein purpura.Inoue CN, Nagasaka T, Matsutani S, Ishidoya M, Homma R, Chiba Y. Clin Rheumatol. 2008 Dec; 27(12):1489-96. Epub 2008 Jul 24. [Case of Henoch-Schönlein purpura nephritis successfully treated with tonsillectomy and steroid pulse therapy]. [Nihon Jinzo Gakkai Shi. 2009] [Case of Henoch-Schönlein purpura nephritis successfully treated with tonsillectomy and steroid pulse therapy].Iwamoto M, Wakabayashi M, Hanada S, Kobayashi N, Hata T, Ando R. Nihon Jinzo Gakkai Shi. 2009; 51(4):484-9. Review Tonsillectomy and steroid pulse therapy for IgA nephropathy. [Tohoku J Exp Med. 2011] Review Tonsillectomy and steroid pulse therapy for IgA nephropathy.Moriyama T, Nitta K. Tohoku J Exp Med. 2011; 224(4):243-50. Review Tonsillectomy combined with steroid pulse therapy induces clinical remission of IgA nephropathy. [Adv Otorhinolaryngol. 2011] Review Tonsillectomy combined with steroid pulse therapy induces clinical remission of IgA nephropathy.Komatsu H, Fujimoto S. Adv Otorhinolaryngol. 2011; 72:57-9. Epub 2011 Aug 18. See reviews... See all... Recent activity Clear Turn Off Turn On Impact of periodontal treatment in combination with tonsillectomy plus methylpre... Clin Nephrol. 2012 Feb ;77(2):137-45. PubMed Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more... You are here: NCBI > Literature > PubMed Write to the Help Desk Simple NCBI Directory Getting Started NCBI Education NCBI Help Manual NCBI Handbook Training & Tutorials ResourcesChemicals & BioassaysData & SoftwareDNA & RNADomains & StructuresGenes & ExpressionGenetics & MedicineGenomes & MapsHomologyLiteratureProteinsSequence AnalysisTaxonomyTraining & TutorialsVariation Popular PubMed Nucleotide BLAST PubMed Central Gene Bookshelf Protein OMIM Genome SNP Structure Featured GenBank Reference Sequences Map Viewer Genome Projects Human Genome Mouse Genome Influenza Virus Primer-BLAST Sequence Read Archive NCBI Information About NCBI Research at NCBI NCBI Newsletter NCBI FTP Site NCBI on Facebook NCBI on Twitter NCBI on YouTube NLM NIH DHHS USA.gov Copyright | Disclaimer | Privacy | Accessibility | Contact National Center for Biotechnology Information, U.S. National Library of Medicine 8600 Rockville Pike, Bethesda MD, 20894 USA