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Editorial
. 2021 Feb 8;16(2):179-181.
doi: 10.2215/CJN.19201220. Epub 2021 Jan 21.

Steroid Regimen for Children with Nephrotic Syndrome Relapse

Anna Elizabeth Williams  1 , Rasheed A Gbadegesin
Affiliations
Editorial

Steroid Regimen for Children with Nephrotic Syndrome Relapse

Anna Elizabeth Williams et al. Clin J Am Soc Nephrol. .
No abstract available

Keywords: children; glomerular disease; idiopathic nephrotic syndrome; nephrotic syndrome.

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Figures

Figure 1.
Figure 1.
Hypothalamic-pituitary-adrenal (HPA) axis suppression from corticosteroid therapy in nephrotic syndrome (NS) can predispose to relapse. T regulatory (Treg) cell and T helper 17 (Th17) cell imbalance is associated with development of nephrotic syndrome and relapse. When nephrotic syndrome is treated with corticosteroids, this re-establishes the proper immunologic balance of Treg and Th17 cells, leading to remission. Prolonged corticosteroid therapy for treatment of nephrotic syndrome leads to HPA axis suppression, so that when a trigger such as an infection arises, the patient is unable to produce enough endogenous glucocorticoids to prevent relapse. When the duration of corticosteroid therapy is shortened, less HPA axis suppression occurs and remission is maintained, even when an immunologic trigger arises.
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References

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