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Idiopathic membranous nephropathy in children
Beom Hee Lee1, Hee Yeon Cho, Hee Gyung Kang
1Department of Pediatrics, Seoul National University Children's Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea.
Pediatric Nephrology (Berlin, Germany)
|September 5, 2006
Summary
Idiopathic membranous nephropathy in children often presents as asymptomatic proteinuria or nephrotic syndrome. While proteinuria resolves, nephrotic syndrome indicates a poorer prognosis, especially with renal vein thrombosis.
Area of Science:
- Pediatric Nephrology
- Glomerular Diseases
Background:
- Idiopathic membranous nephropathy (MN) is a rare glomerular disease in children.
- It can manifest as asymptomatic proteinuria (AP) or nephrotic syndrome (NS).
Purpose of the Study:
- To analyze the clinical course and prognostic factors of childhood idiopathic MN.
- To evaluate treatment outcomes for AP and NS in pediatric patients.
Main Methods:
- Retrospective review of 19 pediatric idiopathic MN cases from 1977 to 2005.
- Analysis of clinical presentation, treatment modalities, and patient outcomes.
Main Results:
- All 8 patients with AP achieved remission.
- Only 3 of 11 NS patients responded to corticosteroids alone.
- Cyclosporine aided remission in 3 steroid-resistant NS cases.
- Presentation with NS and renal vein thrombosis (RVT) were poor prognostic factors.
Conclusions:
- Childhood idiopathic MN with AP has a favorable prognosis.
- NS in pediatric MN requires further immunosuppression for better outcomes.
- RVT is a significant predictor of poor renal outcomes in pediatric MN.
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