Abstract
Background and aim of work: Levamisole is an antihelminthic agent with immunomodulatory properties. It resulted in a significant reduction in relapse rate and prednisone dosage in frequently relapsing and/or steroid-dependent nephrotic children with few side effects. This work aimed to study the effectiveness and side effects of levamisole as second-line therapy in patients with steroid-dependent and/or frequently relapsing nephrotic syndrome in our locality in Sohag, Egypt.
Patients and Methods: A retrospective study included records of patients with idiopathic steroid dependent and frequently relapsing nephrotic syndrome who followed in our Sohag pediatric nephrology clinic in the period from 2010 to 2020 and used levamisole. Relapse frequency/yr and steroid dependent dose before, during, and after levamisole use were calculated. Levamisole complications were recorded.
Results: It included 38 children (26 boys and 12 girls). Mean age at disease onset (3.9±1.8 yr). Levamisole course was 3-12 months according to the response. During levamisole course; relapses stopped in 12 (32%) patients, reduced in 5 (13%), and were the same in 21 (55%). After levamisole stoppage; no relapses were in 3 (8%) patients, infrequent relapses in 11 (29%), and frequent relapses in 24 (63%). Frequency of relapses/yr and mean steroid-dependent dose before levamisole use were significantly higher in the failed group than in the successful group (P-value 0.001 for both). No levamisole complications were recorded.
Conclusion: Levamisole is a cheap, safe, and effective drug in steroid-dependent and frequently relapsing nephrotic syndrome.