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Severe steroid-responsive nephrosis associated with hypersensitivity.

D H Sandberg, C W Bernstein, R M McIntosh

    Lancet (London, England)
    |February 19, 1977
    PubMed
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    Food allergies may trigger childhood nephrotic syndrome. Cow

    Area of Science:

    • Pediatric Nephrology
    • Clinical Immunology
    • Allergy and Immunology

    Background:

    • Idiopathic nephrotic syndrome (INS) is a significant kidney disorder in children.
    • The etiology of INS is often unclear, but immune system dysregulation is implicated.
    • Dietary factors are increasingly being explored as potential triggers for chronic conditions.

    Purpose of the Study:

    • To investigate the potential role of cow's whole milk hypersensitivity in pediatric idiopathic nephrotic syndrome.
    • To determine if dietary challenges with cow's milk can elicit nephrotic syndrome relapse.
    • To explore immunological markers associated with milk challenge in these patients.

    Main Methods:

    • Six patients with INS were placed on an elemental diet until proteinuria resolved.

    Related Experiment Videos

  • Patients underwent a cow's milk challenge, and clinical and biochemical parameters were monitored.
  • Intradermal skin testing with cow's milk extract was performed on all participants.
  • Main Results:

    • Four out of six patients experienced relapse of proteinuria, edema, and decreased urine output after cow's milk challenge.
    • Serum IgG concentrations decreased in four patients post-challenge.
    • All six patients showed acute alterations in plasma C3 complement component and positive skin tests to cow's milk.

    Conclusions:

    • Cow's milk hypersensitivity may be a contributing factor to the clinical and biochemical manifestations of idiopathic nephrotic syndrome in some children.
    • Food allergies should be considered in the differential diagnosis and management of recurrent or persistent nephrotic syndrome.
    • Further research is warranted to elucidate the mechanisms linking food hypersensitivity and nephrotic syndrome.