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Year : 2021  |  Volume : 6  |  Issue : 2  |  Page : 86-95

Clinicopathological spectrum and response pattern of adolescent-onset idiopathic nephrotic syndrome: Are they different from young children?

1 Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2 Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Correspondence Address:
Prof. Ranjit Ranjan Roy
Room No. 323, Block-D, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000,
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pnjb.pnjb_24_21

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Background: There is a scarcity of published data regarding the clinical and pathological pattern of idiopathic nephrotic syndrome in adolescents in our country. Materials and methods: A retrospective analytical study was undertaken on 550 children with idiopathic nephrotic syndrome admitted to Bangabandhu Sheikh Mujib Medical University from January 2019 to July 2021. Data regarding clinical and laboratory parameters, current clinical status of the patients and their steroid responsiveness, complications, types of histopathological lesions, and treatment profile were retrieved from departmental automation. These parameters of the patients whose disease onset between 1 and <10 years of age (Group A) were compared to the same parameters of those with onset of disease between 10 and 18 years (Group B). Results: We found that hypertension, hematuria, and azotemia were more prevalent in childhood group than adolescent group. IFRNS was the most common disease course in Group B (56.2%) and more of them were currently on remission (80%). SRNS was more common in Group A (16.7%) and more of them were on relapse (76.16%) currently during the last follow-up. Precipitating factors such as infection and asthma were more in younger children. The rate of complication was more in childhood group in comparison to adolescent group. On renal biopsy specimen, minimal change disease (MCD) was the most common histological lesion in adolescent group (24.86%) compared to childhood group (16.16%). Adolescents (Group B) required less amount of second- and third-line immunosuppressive drugs than younger children (Group A). Conclusions: The overall clinical and histological condition was more favorable in adolescent group in comparison to childhood group in our setup. These findings necessitate larger prospective study in the future for further validation of this observation.

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