meprednisone and deflazacort

Topics: Adolescent; Adult; Cell Count; Child; Child, Preschool; Female; Glucocorticoids; Humans; Immunosuppressive Agents; Kidney Transplantation; Lymphocyte Culture Test, Mixed; Male; Postoperative Care; Prednisone; Pregnenediones; T-Lymphocytes, Cytotoxic

In children who have undergone successful renal transplantation, the failure of linear growth, a cushingoid appearance and obesity decrease self-esteem and hamper rehabilitation. Changes in kidney function, growth velocity, weight to height ratio and growth hormone (GH) secretion were studied before, and 2 years after, replacement of methylprednisone (6 +/- 0.3 mg/day; mean +/- SEM) by deflazacort (9.6 +/- 0.5 mg/day) 4 years after renal transplantation in 10 patients aged 9-16 years with stable renal function. Serum creatinine and creatinine clearance did not change significantly during deflazacort treatment. In 8 patients at Tanner stage I, growth velocity increased significantly during the 1st and 2nd year of deflazacort therapy (p < 0.01 and p < 0.005, respectively). Weight to height ratio decreased significantly during the 1st and 2nd year of deflazacort treatment (p < 0.005, p < 0.02, respectively) though in 3 patients, this returned to base levels after 2 years of deflazacort therapy. The mean spontaneous GH secretion increased significantly (p < 0.05). There was a correlation between growth velocity and spontaneous GH secretion during deflazacort therapy. The cushingoid appearance decreased in the majority of patients. Renal function remained stable.

Topics: Adolescent; Anti-Inflammatory Agents; Body Height; Child; Dose-Response Relationship, Drug; Female; Growth Hormone; Humans; Kidney Transplantation; Male; Prednisone; Pregnenediones; Radioimmunoassay; Time Factors