1. Authors- Dr. Shreesh Bhat, Dr. Ashish Agrawal,
Dr. Narayan Prasad Modi, Dr. Saroj Kumar Satpathy.

2. Introduction

3.  Nephrotic syndrome is a common renal pediatric
disorder reported in 20 – 40 million population
worldwide, with incidence in Indian subcontinent being
90-100 per million.
 It is characterized by generalized edema, heavy
proteinuria, hypo-albuminemia, and hyperlipidemia.

4. 95% cases of nephrotic syndrome are idiopathic with
80% cases having minimal change histology
synonymous with steroid responsive nephrotic
syndrome.

6. Study of relationship between Nephrotic syndrome
especially steroid responsive type and clinical allergies
in children.

7. Objectives
1. Relate concurrence of steroid responsive nephrotic
syndrome and clinical allergies.
2. Relate Serum IgE levels in steroid responsive
nephrotic syndrome and clinical allergies.
3. Relate familial occurrence of allergy in cases of
nephrotic syndrome.

8. Materials and Methods.
 Type of Study:- Cross-sectional study
 Place of study :- Dept. of Pediatrics, SCB Medical college
and SVPPGIP, Cuttack, Odisha.
 Duration of Study:- 2 years.
(Sept. 2013 to Aug. 2015 )
Appropriate consent from all participants and Ethics committee approval taken before
starting study.

9. Three groups were studied with sample size and
description as follows.
 Group A- Cases (Nephrotic Syndrome).(n=80)
 Group B (Control) - Children primarily presenting for
non atopic conditions but who may be having history
of or existing clinical allergy.(n=70)
 Group C (Control) - Healthy Children. (n=40)

10.  INCLUSION CRITERIA:
 Children 2-10 years of age.
 Children having clinical and biochemical evidence of
Nephrotic syndrome.
 EXCLUSION CRITERIA:
 Children < 1year.
 Children with nephrotic syndrome with associated
features of azotemia, hematuria, hypertension.
 Children with immunodeficiency disorders.
 Children with edema due chronic liver disease, CCF,
severe malnutrition etc.

11. Observations

12. Sex Distribution among study groups.
53
40
20
27
30
20
0
10
20
30
40
50
60
70
80
90
Group A Group B Group C
Female
Male

13. Incidence of allergy in Nephrotic syndrome.
51
64%
29
36%
Cases of Nephrotic Syndrome (n=80)
With Allergy
Without Allergy

14. INCIDENCES OF ALLERGIC DISORDER
AMONG STUDY GROUPS.
51
13
5
29
57
35
0
10
20
30
40
50
60
Group A Group B Group C
With Allergy
Without Allergy
(p<0.05)

15. Incidence of clinical allergies in First attack
and relapsing nephrotic syndrome.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
First Attack Relapsing
7 44
3 26
Without Allergy
With Allergy

16. Incidence of various allergies in nephrotic
syndrome.
0
5
10
15
20
25
30
35
40
45
50
Allergic
Rhinitis
Atopic
dermatitis
Bronchial
Asthama
Food
Allergy
46
9
7
2
Number of Nephrotic Syndrome cases.
Number of Nephrotic
Syndrome cases.

17. INCIDENCE OF RAISED IG-E LEVEL AMONG
STUDY GROUPS.
76
10
0
4
60
40
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Group A Group B Group C
Normal IgE
IgE Raised (>300IU)

18. Incidence of allergy among first order
relatives.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Group A Group B Group C
40
26 13
40
44 27
No Atopy History
With Atopy history in
First relative
p<0.05

19. Incidence of eosinophilia among study
groups.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Group A Group B Group C
47
5
0
33
65
40
No Eosinophilia
Eosinophilia

20. Recommendations
In spite of best efforts taken for the study, the following
improvements are suggested during further research.
 Study should be conducted at a grass root level.
 Larger studies could further validate results.
 Appropriate follow-up done.
 Relation to steroid intake studied.

21. Conclusion

22. In the present study of the 80 cases presenting with
nephrotic syndrome, the incidence of four main allergies
in control groups B and C (19%, 13%) were significantly
lower.
64% cases (p<0.05; Significant) of nephrotic
syndrome presented with clinical allergies.

23. Here, nephrotic syndrome was found to have a greater
incidence of association with these allergies:-
Allergic rhinitis (58%), Allergic dermatitis (12%),
Asthma (9%) and food allergy (2%).
Allergic manifestation, related to relapse in none it was a
consistent or concurrent happening.

24. In this study we found a strong significant association
between Nephrotic syndrome and clinical allergies.
It was further supported by elevated levels of Serum IgE
in our cases of Nephrotic syndrome.
 95% cases had serum IgE >300IU/ ml.
 64% cases had a mean level of >1550 IU/ml. These were
the cases presenting with clinical allergies.

25. Finally, there was a significant familial history of allergy
in cases of nephrotic syndrome.

26. Thank You!!

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