ABSTRACT
To assess the atopic state in patients with SRNS, serum ECP levels were measured by chemiluminescent enzyme immunornetric assay and skin prick tests were done in 32 children with SRNS and 10 age- and sex-matched healthy children without evidence of atopy. Out of the nephrotic patients, 19 children had active disease [Group I] and 13 were in remission [Group II]. Among group I, 7 children were frequent relapsers [FR] while 12 were infrequent relapsers [IR] or non-relapsers [NR]. We found that 37.5% of our patients had positive skin prick tests. Serum ECP levels were elevated in group I patients [= 25.3 and Interquartile range [IQR] = 13.8-33.6 ng /ml] and group II patients [median = 14.2 and IQR = 12.0-20.2 ng/ml] compared to controls [median = 9.1 and IQR = 7.2-13.5 ng/ml, P < 0.0001 and 0.006 respectively]. Similarly, patients with negative skin prick tests in group land group II had higher ECP levels compared to controls [P = 0.007 and 0.07 respectively]. Among group I, ECP levels were higher in patients with positive skin prick tests to those with negative tests [P < 0.0001] and in FR compared to IR and NR [P = 0.05]. Moreover, there was an association between the development of frequent relapses and positivity of skin prick tests [Fishers Exact = 0.07 relative risk = 6.4 and confidence interval = 1.0-41.2]. In conclusion, serum ECP levels are elevated in children with active SRNS. ECP could be considered as one of the neutralizing cations involved in the pathogenesis of proteinuria in these patients. Atopy could be assumed as a risk factor for the development of frequent relapses, so the value of a course of non-steroidal anti-inflammatory drug [as ketotifen] infrequently relapsing nephrotic children should be evaluated