View Full Version : Group of G.N.presented with nephrotic disease

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06-05-2009, 09:28 AM
Group of G.N.
presented with nephrotic $

Minimal lesion (Nil $):
This is not a true glomerulonephritis due to absence of inflammation& inflammatory changes.
Common in children.
20 % of adult nephrotic $.
Steroid sensitive.
Selective proteinuria.
Renal failure usually does not occur.
1 ry idiopathic.
2 ry NsAID - lymphoma.

light almost normal (nil)
E / M fusion of foot process, of epith. Cells or
Immunoflorescence - ve (nil) (no Ab or C)

C /P: Nephrotic $ see later.

ttt: (4-2-4)

* Prednisolone 60 mg / m2 orally for 4 wks or until proteinuria
disappears. ( normal body surface area 1.73 m2).

*When the urine has been free from proteins continue the
drug for 2 wks then prednisolone should be gradually
reduced over 4 wks.
*if relapse occurs on withdrawal of steroid remission is induced with steroid therapy once more & a course of
cyclophosphamide can be given

Cyclophosphamide may be used 2 mg / kg / d and continued for 2 wks after remission or withdrawn after 6 wks if no response.
Indicat. Steroid resistant.
Steroid dependent
Frequent relapses
Recently cyclosporine can be used also.


There is remission and exacerbation
Relapses occurring many years later are recognized but even I in the long term there does not seem to be any deterioration of
renal function.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)