RESPONSE TO METHYLPREDNISOLONE BOLUS IN CHILDREN TREATED FOR NEPHROTIC SYNDROME AT THE PEDIATRIC NEPHROLOGY UNIT IN ABIDJAN

Introduction: The objective of this study was to describe the modalities of the responses observed following the realization of a bolus of methylprednisolone in children treated for nephrotic syndrome in the pediatric nephrology unit in Abidjan in order to assess the need for its realization in our practice.

Methods: we carried out a descriptive and analytical cross-sectional study in patients followed up in the pediatric nephrology unit for a nephrotic syndrome and having benefited from the administration of 3 boluses of methylprednisolone at a dosage of 1g/1.73m² between 2013 and 2021.

Results: we collected 33 patients aged 2 to 12 years in 72.7% of cases with a male predominance (sex ratio=2.66). The bolus indication was the persistence of proteinuria (100%) after four to six weeks of corticosteroid therapy at 60mg/m². A biological assessment in search of a secondary cause had been carried out (48.8%) and presented abnormalities in 26.6% of cases. The bolus was done in hospitalization in 54.5% of cases. All patients benefited from gastric protection and a biological assessment before each bolus. During the realization of the bolus, incidents were observed (27.2%): arterial hypertension (22.2%), fever (55.5%), hyperglycaemia (11.2%). The post-bolus evaluation revealed 66.8% corticosteroid-resistant patients and 27.2% corticosteroid-sensitive.

Conclusion: The bolus of methylprednisolone made it possible to catch up in a third of the cases of corticosteroid-sensitive patients, hence the need for its realization when the conditions allow it.