Description of Renal Biopsy in Frequently Relapsing and Corticosteroid Non Responsive Nephrotic Syndrome in Childhood

D. Bahrun; M. Nazir; K. Yangtjik N.

doi:10.14238/pi28.9-10.1988.192-9

D. Bahrun Department of Child Health, Universitas Sriwijaya Medical School/Moh. Hoesin Hospital, Palembang, South Sumatera
M. Nazir Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia
K. Yangtjik N. Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia

DOI: https://doi.org/10.14238/pi28.9-10.1988.192-9

Keywords: renal biopsy; relapsing; non responsive nephrotic syndrome; nephrotic syndrome

Abstract

A study of 71 children with nephrotic syndrome admitted to the Department of Child Health, Medical School, Sriwijaya University Palembang General Hospital between November 1981 and November 1983 has been reported.

Of the 71 children, there were 50 (70.4%) boys and 21 (29.6%) girls, in which 31 were less than 6 years of age. During the first eight weeks complete rem1sswn was found in 66 patients. The other five were steroid resistant.

Among the 66 patients who responded to steroid, 61 had remission with the first 4 weeks. Further observation up to two years, 3 patients were still in remission, 36 had one relapse and 22 had frequent relapses.

The other 5 patients, who had remission on the second 4 weeks, one had one relapse, two had frequent relapses and the other two were not available for follow up.

Renal biopsy was performed in 31 patients. The representative results of the renal biopsy were found in only 20 patients :

Eleven patients showed minimal change nephrotic syndrome (MCNS). Ten of these patients had frequent relapses while one patient was steroid resistant. Two had renal insufficiency.
Three patients had focal glomerulosclerosis (FGS); two of them were frequently relapsing patients and the other one had steroid resistant.
Four patients had mesangial proliferative glomerulonephritis (Mes. PGN). All of them had frequent relapses.
One patient with diffuse proliferative glomerulonephritis (DPGN) was steroid resistant.
One patient with crescentic glomerulonephritis (CrGN) was also steroid resistant.

References

1 . ARNElL, G.C.; LAM, C.N.: Long Term Assesment of Steroid Therapy in Childhood Nephrosis. Lancet ii : 819 (1966).
2. ARNElL, G.C.: The Nephrotic Syndrome. Pediat. Clins N. Am. 18 : 547 (1971).
3. CHURG, J.; HABIB, R.; WHITE, R.H.R.: Pathology of the Nephrotic Syndrome in Children. Lancet i : 1299 (1970).
4. HABIB, R.; LEVY, M.; GUBLER, M.C.: Clinicopathologic Correlations in the Nephrotic Syndrorr,e. Paediatrician 8 : 325 (1979).
5. International Study of Kidney Disease in Children; Prospective, Controlled Trial of Cyclophosphamide Therapy in Children with the Nephrotic Syndrome. Lancet ii : 423 (1974).
6. International Study of Kidney Disease in Children; The Primary Nephrotic Syndrome in Children. Identification of Patients with Minimal Change Nephrotic Syndrome from initial response to prednison. J. Paediat. 98:561 (1981).
7. Me ENERY, P .T.; STRIFE, C.F.: Nephrotic Syndrome in Childhood . Management and Treatment in Patients with Minimal Change Disease, Mesangial Proliferation or Focal Glomerulosclerosis. Pediat. Clins N. Am. 4 : 875 (1982).
8. MURPHY, W.M.; JUKKOLA, A.F.; ROY, S.: Nephrotic Syndrome with Mesangial Cell Proliferation in Children a Distinct Entity? Am.J. clin Path. 72 : 42 (1979) .
9. RANCE, C.P.; ARBUS, C.S.; BALFE, J .W.: Management of Nephrotic Syndrome in Children, Pediat. Clins N. Am. 23 : 735 (1976).
10. SOLCEDO, J.R.; PARRISH, J .R.: Renal Biopsies. Pediat. Clins N. Am. 23 : 903 (1976).
11. SCHWARTZ, M.W.; SCHWARTZ, G.Y.; CORNFIELD, D.: A 16 Years follow up Study of Children with Nephrotic Syndrome. Pediatrics 54 : 547 (1974).
12. WHITE, R.H.R.; GLASGOW, E.F.; MILLS, R.J.: Clinicopathological Study of Nephrotic Syndrome of Childhood. Lancet i : 1353 ( 1970) .