Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Although the combination of tonsillectomy and steroid pulse therapy is frequently employed in adult patients with IgA nephropathy in Japan, the Japanese pediatric guidelines recommend this approach only weakly and for a limited subset of cases owing to insufficient evidence. In severe pediatric cases, oral corticosteroids are often administered as long-term therapy; however, prolonged exposure to these agents is associated with substantial adverse effects, particularly impaired linear growth and metabolic complications, which are especially concerning during adolescence. To mitigate these risks, a regimen has been attempted in which mizoribine is administered after tonsillectomy and steroid pulse therapy, thereby avoiding the need for subsequent maintenance with oral steroids. The present study summarizes the clinical course and outcomes of five patients treated with this regimen at our institution.
We retrospectively reviewed the medical records of patients who underwent tonsillectomy followed by steroid pulse therapy and subsequent mizoribine administration without maintenance oral steroids. Clinical variables included age at disease onset, renal biopsy findings, concomitant therapies, follow-up duration, clinical response, and adverse events. Clinical remission was defined in accordance with standard criteria for IgA nephropathy: “complete remission” as resolution of both hematuria and proteinuria, and “partial remission” as improvement in either.
Five patients (three males and two females) were included. Age at onset ranged from 10.4 to 14.4 years. Renal biopsy revealed mesangial proliferation in ≥80% of glomeruli in two patients, ≥50% in two, and <50% with cellular crescents in 25% of glomeruli in one. All patients received angiotensin-converting enzyme inhibitors with mizoribine; one also received antiplatelet and anticoagulant agents. The median follow-up duration was 3.0 years.
Two patients achieved complete remission, including one who discontinued all medications, while the remaining three achieved partial remission. Notably, no patient experienced steroid-related adverse effects such as growth impairment or Cushingoid features. One patient developed transient glycosuria during pulse therapy, which resolved spontaneously.
The combination of tonsillectomy, steroid pulse therapy, and subsequent mizoribine administration yielded favorable outcomes in all patients, with either complete or partial remission. Compared with conventional long-term oral steroid regimens, this approach may reduce adverse effects, particularly growth impairment, which is a critical concern in adolescents. Nonetheless, the small sample size and retrospective design limit the generalizability of these findings, and larger prospective studies are warranted to confirm efficacy and safety.
In conclusion, our findings suggest that tonsillectomy combined with steroid pulse therapy and subsequent mizoribine administration may represent a promising therapeutic strategy for adolescent patients with IgA nephropathy, particularly those approaching adulthood, in whom growth and quality-of-life considerations are paramount.
