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Indian Pediatr 2012;49: 844
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Steroid Sensitive Nephrotic Syndrome and
Steroid Toxicity: What to do Next?
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Jyoti Sharma
Assistant Professor,
Department of Pediatrics,
Dr RPGMC Kangra 176 001, (H.P)
Email:
[email protected]
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A 10 year old boy presented to our hospital with nephrotic syndrome
relapse and signs of steroid toxicity in the form of posterior capsular
cataract, affection of linear growth and stage 2 hypertension, in
addition to steroid induced adiposity and fungal infection of the scalp
resulting in cicatricial alopecia. He was diagnosed as nephrotic
syndrome 6 months back. He went into remission with steroid therapy, but
was inadvertently taking steroids in high doses for 5 months. When the
dose of steroid was tapered, patient had relapse of nephrotic syndrome.
As per IAP consensus guidelines for steroid sensitive nephrotic syndrome
[1], relapse is to be treated with steroids first. As this patient is
suffering from serious steroid toxicity already, is it appropriate to
use second line drugs straightway?
Reference
1. Consensus Statement of Management of Steroid Sensitive Nephrotic
Syndrome. Indian Pediatric Nephrology Group, Indian Academy of
Pediatrics. Indian Pediatr. 2008;45:203-14.
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