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Tuberculosis infection in children with proteinuria/nephrotic syndrome

Hanna Szymanik-Grzelak1, Elżbieta Kuźma-Mroczkowska1, Piotr Skrzypczyk1

  • 1Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.

Central-European Journal of Immunology
|December 6, 2017
PubMed

Insights

Children with nephrotic syndrome and tuberculosis experienced proteinuria resolution after anti-TB treatment. This highlights the importance of screening for tuberculosis in children with nephrotic syndrome.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Immunology

Background:

  • Children with nephrotic syndrome (NS) exhibit increased infection susceptibility due to disease-related immunodeficiency and immunosuppressive treatments.
  • Tuberculosis (TB) screening is crucial in pediatric NS patients, especially before initiating corticosteroid (GCS) therapy, or in cases of leukopenia, NS relapse, or non-nephrotic proteinuria.

Observation:

  • This study involved 4 children (mean age 7.6 ±5.1 years) with NS/proteinuria and concurrent TB infection (3 latent, 1 lymph node).
  • Tuberculosis diagnosis was confirmed by Interferon-Gamma Release Assay (IGRA); chest X-rays were normal, but CT revealed lymph node enlargement in one case.
  • Children received anti-TB medications (isoniazid, or isoniazid, rifampicin, pyrazinamide) and standard NS treatments (prednisone or enalapril).

Findings:

  • All 4 children achieved complete proteinuria remission during the course of anti-TB treatment.
  • The study demonstrates a significant positive impact of tuberculosis treatment on proteinuria in pediatric NS patients.

Implications:

  • Early diagnosis and treatment of tuberculosis in children with nephrotic syndrome can lead to the resolution of proteinuria.
  • Integrating TB screening into the management of pediatric nephrotic syndrome is essential for improving patient outcomes and preventing complications.
  • This approach may offer a novel therapeutic strategy for managing proteinuria in this vulnerable population.

Keywords:
childrennephrotic syndromeproteinuriatuberculosis

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