CLINICOPATHOLOGICAL FEATURES OF THE NEPHROTIC SYNDROME IN SOUTH-AFRICAN CHILDREN

  • 1 January 1979
    • journal article
    • research article
    • Vol. 48  (189) , 77-91
Abstract
One hundred and thirty children [74 Africans, 56 Indians] with contrasting clinicopathological patterns of the nephrotic syndrome are described. Of African children, 86% had obvious structural glomerular lesions which were associated with unresponsiveness to steroids while 75% of Indians had minimal change nephrotic syndrome which was steroid responsive. The treatment history of a further 41 unbiopsied children with nephrotic syndrome (9 Africans, 32 Indians) supports and emphasizes this difference. Extramembranous and a tropical variety of extramembranous (36.5%) together with proliferative (20.2%) lesions accounted for most of the histological types in African children. The disease in Indian children was similar to that in other countries in age of onset, sex distribution, frequency of histological types and steroid responsiveness although there were a preponderance of frequent relapsers (69%). Africans differed from children in other continents in the frequency of histological categories (therefore in steroid responsiveness) and occasionally in clinical behavior. They also differed from children in tropical Africa in a lower incidence of the disease, male dominance and absence of malarial nephropathy. The etiology of nephrotic syndrome in nearly all the children remains unidentified.