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Mattoo TK, Sanjad S. Current Understanding of Nephrotic Syndrome in Children. Pediatr Clin North Am 2022; 69:1079-1098. [PMID: 36880923 DOI: 10.1016/j.pcl.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Nephrotic syndrome in children is mostly idiopathic in origin. About 90% of patients respond to corticosteroids; 80-90% have at least one relapse and 3-10% become corticosteroid resistant after the initial response. A kidney biopsy is seldom indicated for diagnosis except in patients with atypical presentation or corticosteroid resistance. For those in remission, the risk of relapse is reduced by the administration of daily low dose corticosteroids for 5-7 days at the onset of an upper respiratory infection. Some patients may continue having relapses through adult life. Many country-specific practice guidelines have been published, which are very similar with clinically insignificant differences.
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Affiliation(s)
- Tej K Mattoo
- Department of Pediatrics, Wayne State University School of Medicine, 400 Mack Avenue, Suite 1 East, Detroit, MI 48201, USA.
| | - Sami Sanjad
- American University of Beirut Medical Center, Beirut, Lebanon
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Aberrant Expression of SIRT6 and VNN1 in Peripheral Blood Monocytes of Children with Primary Nephrotic Syndrome and Its Diagnostic and Prognostic Values. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6880974. [PMID: 36159576 PMCID: PMC9499745 DOI: 10.1155/2022/6880974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/22/2022]
Abstract
Objective The objective is to explore the aberrant sirtuin-6 (SIRT6) and Vanin-1 (VNN1) protein expression in peripheral blood monocytes (PBM) of children with primary nephrotic syndrome (PNS) and its diagnostic and prognostic values. Methods 83 child patients with nephrotic syndrome (NS) and 65 healthy volunteers were enrolled in the study. The test of SIRT6 and VNN1 was performed by the Western blot. The receiver operator characteristic (ROC) curve was used to analyze the diagnostic and prognostic value of SIRT6 and VNN1 for child patients with NS. The logistic regression was used to analyze the association of SIRT6 and VNN1 with the prognosis of NS child patients. Results SIRT6 in monocytes in the study group was inferior versus the control, while VNN1 outweighed it. The AUC of the combined detection of SIRT6 and VNN1 for the diagnosis of NS was 0.854, with a sensitivity of 80.0% and a specificity of 80.7%. The AUC of combined detection of SIRT6 and VNN1 for the prognosis of NS was 0.860, with a sensitivity of 84.6% and a specificity of 79.2%. The logistic regression analysis showed that less than 21.09 in SIRT6 was the number of risk factors for the prognosis of NS child patients (P < 0.05). Conclusion SIRT6 and VNN1 are provided with diagnostic and prognostic values for NS.
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Fujinaga S, Endo S, Morishita T, Takemasa Y, Onuki Y, Sakuraya K, Hirano D. Predictors of Treatment Response and Long-Term Outcomes in Young Children with Steroid-Dependent Nephrotic Syndrome Treated with High-Dose Mizoribine as First-Line Steroid-Sparing Agent. TOHOKU J EXP MED 2022; 256:85-91. [DOI: 10.1620/tjem.256.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Shota Endo
- Division of Nephrology, Saitama Children’s Medical Centerl
| | | | | | - Yuta Onuki
- Division of Nephrology, Saitama Children’s Medical Centerl
| | - Koji Sakuraya
- Division of Nephrology, Saitama Children’s Medical Centerl
| | - Daishi Hirano
- Department of Pediatrics, The Jikei University School of Medicinel
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Ehren R, Benz MR, Brinkkötter PT, Dötsch J, Eberl WR, Gellermann J, Hoyer PF, Jordans I, Kamrath C, Kemper MJ, Latta K, Müller D, Oh J, Tönshoff B, Weber S, Weber LT. Commentary on "Pediatric Idiopathic Steroid-sensitive Nephrotic Syndrome Diagnosis and Therapy - Short version of the updated German Best Practice Guideline (S2e)". Pediatr Nephrol 2021; 36:2961-2966. [PMID: 34091755 PMCID: PMC8445862 DOI: 10.1007/s00467-021-05136-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Rasmus Ehren
- Pediatric Nephrology, Children's and Adolescents' Hospital, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marcus R Benz
- Pediatric Nephrology, Children's and Adolescents' Hospital, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paul T Brinkkötter
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases (CECAD), Cologne, Germany
| | - Jörg Dötsch
- Pediatric Nephrology, Children's and Adolescents' Hospital, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Wolfgang R Eberl
- Department of Pediatrics, Städtisches Klinikum Braunschweig, Braunschweig, Germany
| | - Jutta Gellermann
- Pediatric Nephrology, Charité Children's Hospital, Berlin, Germany
| | - Peter F Hoyer
- Center for Children and Adolescents, Pediatric Clinic II, University of Duisburg-Essen, Essen, Germany
| | - Isabelle Jordans
- Bundesverband Niere eV (German National Kidney-Patients Association), Mainz, Germany
| | - Clemens Kamrath
- Division of Pediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany
| | - Markus J Kemper
- Department of Pediatrics, Asklepios Medical School, Hamburg, Germany
| | - Kay Latta
- Clementine Kinderhospital Frankfurt, Frankfurt, Germany
| | - Dominik Müller
- Pediatric Nephrology, Charité Children's Hospital, Berlin, Germany
| | - Jun Oh
- Division of Pediatric Nephrology, Hepatology and Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany
| | - Stefanie Weber
- Department of Pediatrics II, University Children's Hospital, Philipps-University Marburg, Marburg, Germany
| | - Lutz T Weber
- Pediatric Nephrology, Children's and Adolescents' Hospital, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
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Ali S, Al-Shawi S, Hiris L. Serum immunoglobulin E level in children with nephrotic syndrome. BAGHDAD JOURNAL OF BIOCHEMISTRY AND APPLIED BIOLOGICAL SCIENCES 2021. [DOI: 10.47419/bjbabs.v3i01.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background and objective: The most supported theory for Nephrotic Syndrome (NS) etiology is that it is immune-mediated. This study aims to assess the level of serum IgE in children with Steroid Sensitive NS (SSNS) at relapse and remission, and its correlation with the presence of atopy.
Methods: This cross-sectional study was approved by the Department of Pediatrics, College of Medicine, Al-Nahrain University (Baghdad, Iraq) and conducted at Al-Imamain Al-Kadhimain Medical City (Baghdad, Iraq), and Child Central Teaching Hospital (Baghdad, Iraq), and included 31 children SSNS. The data collected was: age, sex, residency, onset of NS, response to steroid, frequency of relapses, and the history of atopy of the patient and his relatives. Serum IgE level was measured during relapse for all patients and for 9 patients while in remission.
Results: Atopy was present in 18 (58.06%) of patients. The median serum IgE level was 295.5 IU/mL (range 54-2864 IU/mL) in relapse, which is significantly higher (P-value =0.006) than in remission 228.5 IU/mL (range 62-2069 IU/mL). Median serum level of IgE in patients with atopy was 290.5 IU/mL (range 24-2864 IU/mL) which was higher than that of patients without atopy (median 231 IU/mL, range 23-1314 IU/m) (P-value = 0.029). Patients required longer period to respond to steroid therapy (>10 days) had a significantly higher median of IgE (341 IU/mL) than those who required <10 days to respond (161 IU/mL) (P-value =0.045).
Conclusions: Increased IgE level is documented during relapse and in atopic children with SSNS. Longer duration to respond to steroid therapy is associated significantly with higher serum IgE during relapse.
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