ABSTRACT
To determine the efficacy of levamisole in steroid dependent [S.D] and frequently relapsing [F.R] nephrotic, from syndrome [N.S]. Quasi-experimental study. Department of Nephrology at The Children's Hospital, Lahore, over a period of 5 years from January 2000 to December 2004. S.D.N.S and F.R.N.S patients between the ages of 1-15 years, were given levamisole on alternate day in a dose of 2.5mg/kg, if either the dosage of steroids to maintain remission was >1mg/kg/every other day [EOD], or Z with CARON 0.5mg/kg/EOD with signs of steroid toxicity. The agent was continued for a period of one year and the steroids were gradually tapered off by 2.5-5mg every four weeks to less than 0.5mg/kg/EOD. The patients were monitored for maintenance of remission and side effects of drug. Seventy patients with a mean age of 5.50 +/- 2.97 years, with male to female ratio of 4:1 were studied. Nineteen [27.14%] patients did not relapse on therapy, while it was ineffective in 11[15.7%]. Rest of 40 [57.14%] patients, though, relapsed during therapy, their duration of remission was prolonged from six months to one year, and dose of corticosteroids could be significantly reduced [0.1-0.3mg/kg/EOD]. It was also observed that levamisole is more effective in older children [>5 years versus <5 years] [P-value 0.03]. The only side effects were transient rash and occasional vomiting. Levamisole is a safe and effective steroid sparing drug, in steroid dependent and frequently relapsing nephrotic syndrome, for the prolongation of remission, especially in older children