Abstract
Remission followed prednisolone therapy in 9 out of 21 Nigerian children with the nephrotic syndrome who had highly selective proteinuria (CG/CA less than 15%). Of these, 5 patients have remained well off all treatment during a follow-up of nearly 5 years, 4 have relapsed more than once but have responded to further courses of prednisolone. 3 of 21 with less selective proteinuria also remitted but all relapsed and only one of these has responded again. The other two have relapsed and further courses of prednisolone have not totally abolished their proteinuria though they are asymptomatic and in good health. Toxicity (hypertension, sometimes with encephalopathy and infection) was commoner in the patients with less selective proteinuria treated with steroids than in those with highly selective proteinuria. 3 steroid-sensitive patients who had had repeated relapses became free from relapse off all treatment after a course of cyclophosphamide, given during steroid-maintained remission. All but 2 of the renal biopsies taken were regarded as abnormal. The lesions were less severe in those who responded than in those who did not. There is some evidence to suggest that Plasmodium malariae may be a cause of some of the steroid-sensitive disease, as well as the steroid-resistant.
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Selected References
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- Adeniyi A., Hendrickse R. G., Houba V. Selectivity of proteinuria and response to prednisolone or immunosuppressive drugs in children with malarial nephrosis. Lancet. 1970 Mar 28;1(7648):644–648. doi: 10.1016/s0140-6736(70)90885-8. [DOI] [PubMed] [Google Scholar]
- Barratt T. M., Soothill J. F. Controlled trial of cyclophosphamide in steroid-sensitive relapsing nephrotic syndrome of childhood. Lancet. 1970 Sep 5;2(7671):479–482. doi: 10.1016/s0140-6736(70)90108-x. [DOI] [PubMed] [Google Scholar]
- Chandra R. K., Manchanda S. S., Srivastava R. N., Soothill J. F. Differential protein clearances in Indian children with the nephrotic syndrome. Arch Dis Child. 1970 Aug;45(242):491–495. doi: 10.1136/adc.45.242.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Churg J., Habib R., White R. H. Pathology of the nephrotic syndrome in children: a report for the International Study of Kidney Disease in Children. Lancet. 1970 Jun 20;760(1):1299–1302. doi: 10.1016/s0140-6736(70)91905-7. [DOI] [PubMed] [Google Scholar]
- FAHEY J. L., MCKELVEY E. M. QUANTITATIVE DETERMINATION OF SERUM IMMUNOGLOBULINS IN ANTIBODY-AGAR PLATES. J Immunol. 1965 Jan;94:84–90. [PubMed] [Google Scholar]
- HARDWICKE J., SOOTHILL J. F., SQUIRE J. R., HOLTI G. Nephrotic syndrome with pollen hypersensitivity. Lancet. 1959 Mar 7;1(7071):500–502. doi: 10.1016/s0140-6736(59)91026-8. [DOI] [PubMed] [Google Scholar]
- HENDRICKSE R. G., GILLES H. M. The nephrotic syndrome and other renal diseases in children in Western Nigeria. East Afr Med J. 1963 May;40:186–201. [PubMed] [Google Scholar]
- Hendrickse R. G., Adeniyi A., Edington G. M., Glasgow E. F., White R. H., Houba V. Quartan malarial nephrotic syndrome. Collaborative clinicopathological study in Nigerian children. Lancet. 1972 May 27;1(7761):1143–1149. doi: 10.1016/s0140-6736(72)91373-6. [DOI] [PubMed] [Google Scholar]
- Ngu J. L., Soothill J. F. Immunoconglutinin and complement changes in children with acute nephritis. Clin Exp Immunol. 1969 Dec;5(6):557–566. [PMC free article] [PubMed] [Google Scholar]
- Soothill J. F., Hendrickse R. G. Some immunological studies of the nephrotic syndrome of Nigerian children. Lancet. 1967 Sep 23;2(7517):629–632. doi: 10.1016/s0140-6736(67)90681-2. [DOI] [PubMed] [Google Scholar]
- Soothill J. F., Steward M. W. The immunopathological significance of the heterogeneity of antibody affinity. Clin Exp Immunol. 1971 Aug;9(2):193–199. [PMC free article] [PubMed] [Google Scholar]