Relapse of nephrotic syndrome triggered by Kawasaki disease

Area of Science:

• Pediatric Nephrology
• Infectious Diseases
• Rheumatology

Background:

• Nephrotic syndrome (NS) is a kidney disorder often triggered by minor infections, allergies, or insect bites.
• Minimal change (MC) disease is a common cause of NS in children, typically responding to steroid therapy.
• Kawasaki disease (KD) is an acute febrile illness affecting medium-sized arteries, primarily in children.

Purpose of the Study:

• To report the first known case of nephrotic syndrome relapse caused by Kawasaki disease.
• To emphasize the importance of considering KD as a potential trigger for NS relapse in pediatric patients.

Main Methods:

• Case presentation of an 8-year-old boy with a history of steroid-dependent NS (minimal change disease).
• Clinical evaluation including assessment for KD diagnostic criteria and urinalysis for proteinuria.
• Treatment with intravenous immunoglobulin and cyclosporine A for NS relapse.

Main Results:

• The patient presented with symptoms fulfilling 5 of 6 diagnostic criteria for KD.
• Proteinuria, indicative of NS relapse, was present upon examination.
• The patient's proteinuria resolved following treatment with intravenous immunoglobulin and cyclosporine A.

Conclusions:

• Kawasaki disease can precipitate a relapse of nephrotic syndrome, particularly minimal change NS.
• This case underscores the need for clinicians to recognize KD as a potential trigger for NS relapse.
• Prompt diagnosis and management of KD may help resolve NS relapses.