Quartan malaria-associated childhood nephrotic syndrome: now a rare clinical entity in malaria endemic Nigeria

Abstract

Overall outcome of CNS has improved significantly compared to the 1960s and 1970s when the poor outcome of QMN was the predominant glomerular lesion in Nigeria. While quartan malaria-associated nephrotic syndrome has become a rare clinical entity, SLE, SCA and HBV infection have become the major secondary aetiologies of CNS in Nigeria.

Lupus nephritis in a Nigerian child: A first documented case report in South-East Nigeria

“…[3,7] Lupus nephritis is the commonest visceral manifestation of SLE and can present as hypertension, nephritic or nephrotic syndrome, acute or chronic renal failure and tubulointerstitial nephritis (TIN). [3,6,8,9] Lupus nephritis has been shown to be the common cause of secondary childhood nephrotic syndrome in Nigeria. [8] Olowu et al, reviewed the etiology of 78 cases of childhood nephrotic syndrome diagnosed by histological findings on renal biopsy over 8 years; 24 cases were of secondary etiology while the rest were idiopathic.…”

“…[3,6,8,9] Lupus nephritis has been shown to be the common cause of secondary childhood nephrotic syndrome in Nigeria. [8] Olowu et al, reviewed the etiology of 78 cases of childhood nephrotic syndrome diagnosed by histological findings on renal biopsy over 8 years; 24 cases were of secondary etiology while the rest were idiopathic. [8] Lupus nephritis was the commonest secondary etiology and accounted for 37.5% of childhood nephrotic syndrome in their series.…”

“…[3,7,10] This classification determines management approach and the prognosis, the higher the class, the worse the prognosis. [3,8,10] Olowu and others in their study of the clinicopathology of childhood-onset renal SLE, documented predominance of class III and IV diseases lupus nephritis in children. [6] Acute renal failure and renal tubular dysfunction were also associated with severe TIN, which occurred in 91% of the cases.…”

“…[3,10] In Olowu and colleague's study with mostly class III and IV disease, they documented a remission rate of 71.4% at end of 12 months, a renal survival rate of 86%, relapse rate of 14.3% and mortality rate of 30%. [2,8] The outcome however was influenced by misdiagnosis and delayed diagnosis. [8] Response to treatment in our index patient is being monitored via clinical evaluation and urinalysis.…”

“…[2,8] The outcome however was influenced by misdiagnosis and delayed diagnosis. [8] Response to treatment in our index patient is being monitored via clinical evaluation and urinalysis. The skin lesion has healed leaving hypo-pigmented patches with some degree of photosensitivity.…”