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What could be the cause of recurring acute nephritis in a 5 year old ?

Dear Sir, My daughter twisha age 5 was suffering from acute nephritis at age of 3. she was on steroids then. she recovered from the same in 6 months. she went in to relapse after 6 months but recovered in 3 weeks. later there were no issues and she was normal. now for past 4 months she is regularly getting few symptoms as seen at age of 3 like swollan eyes, aulbumin fluctuate from plus one to plus four. I have shown here to child specialist as well as nephrologist . she has under gone various test for kidney such as sonography, dsma scan, urine creatin ratio, blood tests etc. she showns symptoms and then goes back to normal. this is being happening for last 3 months. Doctors are not able to judge the cause. all reports show that kidney is normal, but cause is not yet traceable. Request to guide us on the issue as we are very much concern about her.
Asked On : Fri, 17 Feb 2012
Answers:  1 Views:  85
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Pediatrician, Infectious Diseases 's  Response
Hello Manish,

Considering your information your daughter seems more likely to have nephrotic syndrome rather than acute nephritic syndrome.The nephrotic
syndrome is an idiopathic (cause unknown) problem common in this age group and
frequently known to relapse.However since you have been to nephrologist , I assume
they must have evaluated her for the same and provided a most probable

The diagnostic criteria for nephrotic syndrome

Proteinuria greater than 3-3.5 g/24 hours or spot urine protein:creatinine ratio of >300-350 mg/mmol.

Serum albumin more than 25 g/L.
Peripheral oedema.

Severe hyperlipidaemia (total cholesterol often >10 mmol/L) is often present.

So if you feel she has any of these then do discuss it with your doctor.

Even if she doesn't have these symptoms and diagnosis is in favour of nephritis, such recurrent attacks need further evaluation and if all blood tests (like youmentioned) are equivocal then only a renal biopsy can confirm the diagnosis.

If the risk benefit ratio in her case is favourable only then her doctor might suggest to go ahead with renal biopsy.

Hope I have answered your query.

Wishing Twisha a speedy recovery.


Answered: Fri, 17 Feb 2012
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