Treatment failure occurs in up to 30% of patients treated with steroids for inflammatory diseases. The aim of this study was to explore the potential role of 21 cytokines in steroid-resistant inflammatory disease and to develop methods to restore steroid sensitivity through cytokine manipulation. The dexamethasone inhibition of lymphocyte proliferation assay correlates with the outcome of stero...

BACKGROUND Rituximab has emerged as an important medication for patients with steroid-dependent or steroid-resistant nephrotic syndrome. PATIENTS We report the efficacy and safety of therapy with intravenous rituximab, administered once weekly for 2-4 doses, in 193 patients (mean age 10.9, range 2.2-18.7 years) with difficult-to-treat steroid dependence (n = 101), calcineurin inhibitor (CNI)-...

BACKGROUND The clinical management of intravenous immunoglobulin-resistant Kawasaki disease shock syndrome (KDSS) is obscure. CASE CHARACTERISTICS Three children presented with intravenous immunoglobulin-resistant KDSS complicated with myocarditis. OUTCOME All cases were successfully managed with steroid pulse therapy. MESSAGE Steroid pulse therapy is effective in immunoglobulin-resistant...

BACKGROUND A recent randomized control trial in children with steroid-resistant nephrotic syndrome revealed that two doses of rituximab did not reduce proteinuria. CASE CHARACTERISTICS A 14-month-old boy developed refractory steroid-resistant nephrotic syndrome due to focal segmental glomerulosclerosis. OBSERVATION The patient achieved complete remission 11 months after disease onset follow...

Cyclosporine may be considered as state of the art treatment for steroid resistant severe ulcerative colitis. Up to 30-40% of the patients with severe ulcerative colitis will fail to respond to intravenous steroid treatment and would require surgical treatment. I report a case of steroid resistant severe ulcerative colitis, which failed to respond to cyclosporine due to presence of cytomegalovi...

ulcerative colitis is a mucosal-inflammatory disease that usually involves the rectum and extends proximally to involve all or part of the colon. medications for treatment include anti-inflammatory agents such as 5-asa compounds, systemic and topical corticosteroids and immunomodulators. a 33 year-old female and 52 year-old male both diagnosed with severe active ulcerative colitis who were resi...