Levamisole-Induced Reversible Agranulocytosis in Children with Steroid Dependent Nephrotic Syndrome

Levamisole has been used for nephrotic syndrome due to its immunostimulating, immunomodulating, and steroid-sparing effects. Agranulocytosis, a serious side effect of levamisole, was rare and mostly associated with autoimmune disease, neoplastic disease and HLA B27 except one case in a nephrotic syndrome who was treated with high-dose(5mg/kg QOD) levamisole. This 15 year-old girl with steroid dependent nephrotic syndrome, who was negative for HLA B27, was treated with the usual recommended dose of levamisole(2.5mg/kg QOD). She developed agranulocytosis after 5 weeks of therapy and completely recovered in 11 days after discontinuation of levamisole.

The Effect of Nebulized Budesonide and Intreamuscular Dexamethasone in Patients with Moderate Group / 소아알레르기및호흡기학회지

PURPOSE: To evaluate the effect f nebulized budensonide and intramuscular dexamethasone in relieving laryngeal obstruction of croup. METHODS: Forty patients with moderate croup (croup scores of 3 to 7 out of 17) were randomly assigned to budesonide group [1 mg(2 ml) of nebulized budesonide, N=15], dexamethasone group [intramuscular dexamethasone(0.5 mg/kg) and nebulized saline, N=10] and control group(2 ml of nebulized saline, N=15). The changes of croup scores, heart rate, respiratory rate, and arterial oxygen saturation(SaO2) were observed at post-treatment of 2, 24, 36 and 48 hours. The duration of admission and the rates of improvement to the croup score of < or = 1 at the post-treatments were compared. RESULTS: Croup scores at 12, 24 and 36 hours post treatments were 1.7+/-0.8, 1.1+/-0.7 and 0.8+/-0.7 in budensonide group and 2.2+/-0.7, 1.2+/-0.8 and 1.0+/-0.5 in dexamethasone group respectively, which were significantly lower rate, and SaO2 were not significantly different among the three groups. Improved rates to croup score of <1 in budesonide group at post-treatments of 12, 24, and 36 jpirs were 53%, 73% and 87%, which were significantly higher than 0%, 13%, and 47% in control group (p<0.05). Improved rate to croup score of < or = 1 in dexamethasone group was 60