Late Recurrence of Corticosteroid-Responsive Nephrotic Syndrome of Childhood

CHILDREN with minimal-change nephrotic syndrome usually respond to corticosteroid therapy and eventually enter complete remission before reaching adulthood. Although this disease entity is relatively common in both children and adults, it is extremely rare to encounter adult nephrotic patients who had nephrotic syndrome during childhood. We describe here a patient who had typical minimal-change nephrotic syndrome as a child and, after a corticosteroidinduced complete remission lasting 19 years, had severe nephrotic syndrome as an adult. Report of a Case A 26-year-old woman was seen at The Milton S. Hershey Medical Center in March 1977 with edema. In 1953, at the age of 22 months, she had been hospitalized with edema and ascites. Laboratory values at that time had included proteinuria (4+); serum albumin, 1.6 g/dL; BUN, 9 mg/dL; and serum cholesterol, 952 mg/dL. Following the administration of cortisone, 25 mg four times a day for 11 days, she had become