Authors- Dr. Shreesh Bhat, Dr. Ashish Agrawal,

Dr. Narayan Prasad Modi, Dr. Saroj Kumar Satpathy.

Introduction

Nephrotic syndrome is a common renal pediatric

disorder reported in 20 – 40 million population

worldwide, with incidence in Indian subcontinent being

90-100 per million.

It is characterized by generalized edema, heavy

proteinuria, hypo-albuminemia, and hyperlipidemia.

95% cases of nephrotic syndrome are idiopathic with

80% cases having minimal change histology

synonymous with steroid responsive nephrotic

syndrome.

Study of relationship between Nephrotic syndrome

especially steroid responsive type and clinical allergies

in children.

Objectives1. Relate concurrence of steroid responsive nephrotic

syndrome and clinical allergies.

2. Relate Serum IgE levels in steroid responsive

nephrotic syndrome and clinical allergies.

3. Relate familial occurrence of allergy in cases of

nephrotic syndrome.

Materials and Methods.

Type of Study:- Cross-sectional study

Place of study :- Dept. of Pediatrics, SCB Medical college

and SVPPGIP, Cuttack, Odisha.

Duration of Study:- 2 years.

(Sept. 2013 to Aug. 2015 )

Appropriate consent from all participants and Ethics committee approval taken before starting study.

Three groups were studied with sample size and description as follows.

Group A- Cases (Nephrotic Syndrome).(n=80)

Group B (Control) - Children primarily presenting for non atopic conditions but who may be having history of or existing clinical allergy.(n=70)

Group C (Control) - Healthy Children. (n=40)

INCLUSION CRITERIA:

Children 2-10 years of age.

Children having clinical and biochemical evidence of Nephrotic syndrome.

EXCLUSION CRITERIA:

Children < 1year.

Children with nephrotic syndrome with associated features of azotemia, hematuria, hypertension.

Children with immunodeficiency disorders.

Children with edema due chronic liver disease, CCF, severe malnutrition etc.

Observations

Sex Distribution among study groups.

5340

20

27

30

20

0

10

20

30

40

50

60

70

80

90

Group A Group B Group C

Female

Male

Incidence of allergy in Nephrotic syndrome.

5164%

2936%

Cases of Nephrotic Syndrome (n=80)

With Allergy

Without Allergy

INCIDENCES OF ALLERGIC DISORDER AMONG STUDY GROUPS.

51

13

5

29

57

35

0

10

20

30

40

50

60

Group A Group B Group C

With Allergy

Without Allergy

(p<0.05)

Incidence of clinical allergies in First attack and relapsing nephrotic syndrome.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

First Attack Relapsing

7 44

3 26

Without Allergy

With Allergy

Incidence of various allergies in nephrotic syndrome.

05

101520253035404550

AllergicRhinitis

Atopicdermatitis

BronchialAsthama

FoodAllergy

46

97

2

Number of Nephrotic Syndrome cases.

Number of NephroticSyndrome cases.

INCIDENCE OF RAISED IG-E LEVEL AMONG STUDY GROUPS.

76

100

4

6040

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Group A Group B Group C

Normal IgE

IgE Raised (>300IU)

Incidence of allergy among first order relatives.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Group A Group B Group C

4026 13

4044 27

No Atopy History

With Atopy history inFirst relative

p<0.05

Incidence of eosinophilia among study groups.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Group A Group B Group C

47

50

33

6540

No Eosinophilia

Eosinophilia

RecommendationsIn spite of best efforts taken for the study, the following

improvements are suggested during further research.

Study should be conducted at a grass root level.

Larger studies could further validate results.

Appropriate follow-up done.

Relation to steroid intake studied.

Conclusion

In the present study of the 80 cases presenting with

nephrotic syndrome, the incidence of four main allergies

in control groups B and C (19%, 13%) were significantly

lower.

64% cases (p<0.05; Significant) of nephrotic

syndrome presented with clinical allergies.

Here, nephrotic syndrome was found to have a greater

incidence of association with these allergies:-

Allergic rhinitis (58%), Allergic dermatitis (12%),

Asthma (9%) and food allergy (2%).

Allergic manifestation, related to relapse in none it was a

consistent or concurrent happening.

In this study we found a strong significant association

between Nephrotic syndrome and clinical allergies.

It was further supported by elevated levels of Serum IgE

in our cases of Nephrotic syndrome.

95% cases had serum IgE >300IU/ ml.

64% cases had a mean level of >1550 IU/ml. These were

the cases presenting with clinical allergies.

Finally, there was a significant familial history of allergy in cases of nephrotic syndrome.

Thank You!!

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