Numerous reports during the last 60 years have reported a strong association between idiopathic nephrotic syndrome and atopic disorders. Idiopathic nephrotic syndrome can be precipitated by allergic reactions and has been associated with both aeroallergens (pollens, mold, and dust) and food allergies. Patients with idiopathic nephrotic syndrome also may show increased serum immunoglobulin E (IgE) levels. A review of the literature suggests that although some idiopathic nephrotic syndrome cases may be associated with allergies, evidence that it is a type of allergic disorder or can be induced by a specific allergen is weak. Rather, it is likely that the proteinuria and increased IgE levels in patients with idiopathic nephrotic syndrome are caused by increased levels of interleukin 13 observed in these patients. Recent studies suggest that interleukin 13, a known stimulator of IgE response, may mediate proteinuria in patients with minimal change disease because of its ability to directly induce CD80 expression on the podocyte. KeywordsAtopy; nephrotic syndrome; minimal change disease Idiopathic nephrotic syndrome in children is a clinical syndrome associated with a variety of glomerular lesions. Minimal change disease (MCD) is the most common cause of idiopathic nephrotic syndrome. MCD is often abrupt in onset. It can be dramatic in presentation, yet is one of the most rewarding diseases for a physician to manage because response to corticosteroids often is rapid and complete. Because kidney biopsy usually is not performed when the disease responds to corticosteroid therapy, the term MCD has become synonymous with steroid-sensitive nephrotic syndrome. The mechanism(s) underlying the MCD pathogenesis are unknown, although it is believed to be immunologically mediated. 1 Strong evidence suggests that it may be caused by a circulating factor, possibly T-cell related, that causes podocyte dysfunction resulting in massive proteinuria. 2 However, there also have been numerous reports linking MCD with atopic disorders and increases in serum immunoglobulin E (IgE) levels. In this review, we discuss the evidence supporting the association of atopy and whether there may be a common underlying immune disorder that may predispose patients to both conditions. ATOPYAtopy is a term used to describe IgE-mediated diseases. Persons with atopy have a hereditary predisposition to produce IgE antibodies to common allergens and often manifest with 1 or more atopic diseases (asthma, allergic rhinitis, and atopic eczema). Atopic patients mount an exaggerated immunologic response characterized by production of allergen-specific IgE antibodies and positive reactions to extracts of common aeroallergens on skin-prick tests. Type 2 helper T cells (T H 2) from patients with atopy respond to allergens in vitro by expressing such cytokines as interleukin 4 (IL-4) and IL-13 3 (Fig 1A and B). Early Reports of Atopy With MCDIn 1951, Fanconi et al 4 were among of the first to associate atopy and nephrotic syndrome. Forty-three percent of th...

Cardiac troponins levels can predict the severity of myocarditis and the prognosis on the short-term level. Fulminant myocarditis was associated with higher levels of both cTn I & cTn T than acute myocarditis. Despite that fulminant myocarditis has a more aggressive course, the risk of developing cardiomyopathy was less than in acute myocarditis.

Egyptian children with SLE appear to have severe disease on presentation with high SLEDAI scores and high prevalence of lupus nephritis, but respond well to therapy with a favorable short-term prognosis.

Children with mild to moderate sepsis showed significant improvement in inflammatory markers and had shorter PICU admission when enteral feeding was supplemented with omega-3 essential fatty acids.

The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L) compared to controls (mean: 365.55 ± 76.5 ng/L) (P <0.001) and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L) (P = 0.031). Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003) and after dialysis (P <0.001). Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively). Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.