الفهرس 
Nephrotic SyndromeOnly 14 pages are availabe for public view
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Abstract
Nephrotic syndrome is a glomerular disease, in which the glomerular capillary wall becomes no longer impermeable to proteins. Nephrotic syndrome is characterized by nephrotic range proteinuria and the triad of clinical findings associated with large urinary losses of protein: hypoalbuminaemia, edema, and hyperlipidaemia.
Many studies state that the alteration in permselectivity of the glomerular capillary wall in nephrotic syndrome may be immunologically mediated.
Other studies state that this alteration in the immune response is in fact due to an imbalance between TH-1 and TH-2 response being more towards the humoral immune response rather than the cell-mediated immune response.
This theory was confirmed by the presence of increased level of total IgE in nephrotic patients in relation to controls. Also there are different studies which state that nephrotic syndrome occurs among atopic patients, and relapse occurs after introduction of allergen.
In our study we researched the relation between total IgE and response to steroid treatment in nephrotic patients.
Our study included 100 nephrotic patients and 40 controls. Nephrotic patients were subdivided according to their response to steroid treatment into: steroid responsive infrequent relapsers group, steroid responsive frequent relapsers group, steroid dependent group and steroid resistant group. The controls were subdivided into 20 normal children and 20 atopic patients. IgE levels were measured in all groups. The results were statistically analyzed. Correlation between level of Ige was done with the presence or absence of atopic history, the response to steroid therapy and the disease duration.
The study concluded that there was no significant difference in IgE levels in the nephrotic syndrome groups studied. The steroid resistant NS group showed an increase in percentage o Total IgE. This may indicate that high levels of IgE in nephrotic patients may be used as a prognostic factor to indicate steroid resistance.
Moreover, there were no significant diference in total IgE levels in nephrotic patient as regards the presence or absence of atopic history. This may indicate that nephrotic syndrome may be a manifestation of an atopic disease
Total IgE levels decreased with the disease duration. Total IgE was noticed to be high in patients at the beginning of the disease and decreases with management. This was significantly seen in the steroid responsive group infrequent relapsers treated with steroids and the steroid resistant group treated with steroid sparing drugs. This may indicate that the disease is under control.
In the other groups (steroid responsive frequent relapsers and steroid resistant group) this was not significant. This may indicate that the disease pathology is still in progress and needs to be controlled by adding steroid sparing drugs.
So, total IgE can be used in the follow up of cases, indicating the disease activity and response to steroid therapy. The persistence of high IgE levels along the course of the disease may indicate that the disease is not controlled by the currently used treatment and this treatment modality needs to be changed.