Low serum immunoglobulin G--a predictor of frequent relapses in idiopathic nephrotic syndrome

Serum immunoglobulins were measured in 25 children at the onset of nephrotic syndrome, in 20 during remission and in 19 during relapse. On follow up, 10 of them were frequent relapsers (FR). As compared to children who were infrequent relapsers (IFR), frequent relapsers had significantly lower levels of IgG at onset (p less than 0.001) which persisted during remission. IgG in FR at onset and at remission were 27.2 and 42.5% of normal mean as compared to 70.0 and 74.4% of normal mean observed at onset and remission, respectively in IFR. Very low levels of IgG may help predict onset of a tendency towards frequent relapses in children with minimal change nephrotic syndrome.