Levamisole in steroid dependent and frequently relapsing nephrotic syndrome

Olopatadine is an antihistamine (as well as anticholinergic and mast cell stabilizer), sold as a prescription eye drop manufactured by Alcon in one of three strengths: % solution or Pazeo in the United States , % solution or Pataday (also called Patanol S in some countries), and % or Patanol (also called Opatanol in some countries; Olopat in India). It is used to treat itching associated with allergic conjunctivitis (eye allergies ). [1] A steroid-free [2] nasal spray formulation is sold as Patanase , which was approved by the FDA on April 15, 2008. [3] It is also available as an oral tablet in Japan under the tradename Allelock , manufactured by Kyowa Hakko Kogyo. [4]

Levamisole (LEV) has been used as an immunomodulating medication in patients with recurrent aphthous ulcers and as an adjuvant for chemotherapy. LEV, with or without 5-fluorouracil (5-FU), induces multifocal inflammatory leukoencephalopathy (MIL). We identified 31 patients with LEV-induced MIL: 7 from our institution and 24 from a MEDLINE search. Twenty-one patients (%) had been treated with a combination of LEV and 5-FU, while 10 patients had been treated with LEV alone. The onset of MIL was delayed in patients who took LEV and 5-FU in combination compared with the patients treated with LEV alone ( +/- vs. 4 +/- wk, p < ). Colon cancer (%) was the most common indication for LEV administration. Gait ataxia occurred in 20 (%) patients, and dysphagia was noted in 16 (%) patients. Imaging studies revealed periventricular enhancement in 17 (%) patients and supratentorial lesions in 16 (%) patients. Cerebrospinal fluid studies showed lymphocytic pleocytosis in 10 of 21 (%) patients. Early diagnosis of MIL and discontinuation of LEV is essential, yielding good recovery in most cases. Treatment with corticosteroids and/or intravenous immunoglobulin may be needed for this serious inflammatory encephalopathy. Twenty-nine patients exhibited improved clinical status and imaging findings after initial steroid or immunoglobulin treatment. Plasmapheresis may be an alternative regimen for patients with steroid resistance.

Levamisole in steroid dependent and frequently relapsing nephrotic syndrome

levamisole in steroid dependent and frequently relapsing nephrotic syndrome

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levamisole in steroid dependent and frequently relapsing nephrotic syndromelevamisole in steroid dependent and frequently relapsing nephrotic syndromelevamisole in steroid dependent and frequently relapsing nephrotic syndromelevamisole in steroid dependent and frequently relapsing nephrotic syndromelevamisole in steroid dependent and frequently relapsing nephrotic syndrome

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