الفهرس Only 14 pages are availabe for public view
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Abstract
Nephrotic syndrome is one of the commonest renal disorders occurring during childhood. Although the majority of cases respond well to corticosteroid treatment, a significant percentage has steroid dependence or a relapsing course. This, together with corticosteroid resistance, necessitate prolonged and heavy steroid use and/or the introduction of other more aggressive modalities of treatment. Bearing in mind these facts, in addition to the chronic nature of the illness, we sensed the importance of investigating the impact of this condition on two vital processes occurring in childhood and adolescence: growth and puberty.
The present study was conducted at the pediatric nephrology clinic, Children’s Hospital, Ain Shams University. It comprised 60 patients between 4-18 years of age with childhood nephrotic syndrome studied during remission: 30 pre-pubertal children and 30 adolescents. Growth of prepubertal patients and adolescents was assessed by clinical and laboratory methods. Puberty was assessed in adolescents using Tanner staging and those with Tanner staging inappropriate for age were further assessed by hormonal assay. All patients were subjected to full history taking, thorough clinical examination, accurate determination of height, weight, and parents height, laboratory investigations to ensure normal renal functions and a state of disease remission. A hormonal profile was also performed (IGF-1 and IGFBP-3 for all patients and LH, FSH and free testosterone/estradiol (basal and after LHRH analogue provocation) for adolescents showing clinical delayed puberty). Lastly, X-ray of left hand and wrist for determination of bone age was done for all patients.