All issues > Volume 33(7); 1990

Original Article

J Korean Pediatr Soc. 1990;33(7):959-969. Published online July 31, 1990.

Clinical Analysis of Children with Nephrotic Syndrome.

Ki Young Cheong¹, Keon Su Rhee¹

¹Department of Pediatrics, Chungnam National University, Taejeon, Korea

Received: December 28, 1989;  Accepted: March 20, 1990.

Abstract

A clinical analysis was made on 51 cases with nephrotic syndrome who were admitted to Pediatric Department of Chung Nam National University Hospital from January 1st, 1984 to December 31st, 1988. Clinical manifestation, response to the inital continuous steroid therapy, relapsing patterns, factors affecting response to steroid therapy, pathologic findings and difference in laboratory findings between relapser and nonrelapser were evaluated.
Results
were as follows; 1) Among 51 cases, male was 37 cases (72.5%), female was 14 cases (27.5%) and male to female ratio was about 3:1. The most prevalent age group was 5-9 years (Table 1, Fig 1). 2) Gastrointestinal symptoms were noted in 23 cases (45.1%), pretibial pitting edema was noted in all cases and generalized edema was noted in 43 cases (84.3%)(Table 2). 3) Diuresis after steroid therapy was observed in 46 cases (89.7%) and in 36 cases, diuresis was noted within one week (Table 3). In 30 cases (58.8%), proteinuria disappeared and in most patients, 25 cases (49.0%), proteinuria disappeared within 2 weeks after steroid therapy (Table 3). 4) Complete remission was observed in 30 cases (58.8%)，incomplete remission was observed in 15 cases (29.4%) and remaining 6 cases (11.8%) were resistant to steroid therapy (Table 4). 5) Hematuria, hypertension and azotemia were observed in 12 cases (23.5%), 7 cases (13.75%) and 17 cases (33.3%) jrespectively. Nephritic symptoms were more frequently observed in partial respon- der and nonresponder but in complete remission group, nephritic symptoms were observed in 26.7%, 10.0% and 33.3% (Table 6,7,8). 6) U pper respi r a tor y tract infection was frequently associated with relapse (Table 9). In most cases, duration of follow up was less than one year (Table 10). Thirty one of 51 cases (60.9%) relapsed during follow up and most relapsing patient experienced once or twice (Table 11). 7) Renal biopsies were done in 21 cases and primary nephrotic syndrome was 17 cases, pathologic findings were as follows; MCNS 7 cases (33.3%), mesangial proliferative gl이nerulonephritis 3 cases (14.2%), FSGS 5 cases (23.8%), MPGN 2 cases (9.5%)(Table 12). 8) Difference in laboratory findings between relapser and nonrelapser were evaluated with Student’s T test, but there were no statistically significant difference in s-total protein, s-albumin, s-cholesterol and 24 hours urine total protein. Serum IgG was decreased in both group, s-IgA was in normal range and s-IgM was slightly decreased in both group but significance was not noted. In complement system, C3 was normal in both group but C4 was higher in nonrelapsing patients than relapsers and it was statistically significant(p < 0.011)(Table 13,14).

Keywords :Nephrotic syndrome, Steroid therapy