ESPN 50th Annual Meeting

ESPN 2017


 
Patterns of steroid sensitive nephrotic syndrome (SSNS) in children in Tunisia children: a single center experience
ELLAFI ZEINEB 1 MABROUK SAMEH 1 NOUIR SALSABIL 1 AJMI HOUDA 1 TFIFHA MENIAR 1 CHEMLI JALEL 1 HASSAYOUN SAIDA 1 ZOUARI NOURA 1 ABROUG SAOUSSEN 1

1- UNIVERSITY HOSPITAL SAHLOUL
 
Introduction:

 Objective: To describe the clinical patterns and outcome of .steroid sensitive syndrome in Tunisian children

Material and methods:

 We retrospectively investigated clinical characteristics of children diagnosed with SSNS in the department of pediatrics in the university hospital of Sahloul –Sousse (Tunisia) over a period of 16 years.

Results:

 We collected 41 cases (29 boys and 12 girls). A family history of consanguinity and nephrotic syndrome were found respectively in 24,4 % and 14.6%. The mean age at onset was of 4.3 ± 2.3 years. The mean time to remission was 19.2±10.1 days. There were 16 cases of SSNS with infrequent relapses, 5 frequently relapsing SSNS and 20 cases of steroid dependent nephrotic syndrome. The mean time to first relapse was 7.2 ± 9.7 months, with an average number of relapses of 4.3 ±4. No predictive factor of relapse was found. 14 patients required immunosuppressive agents 36.28 ±31.3 months after the first outbreak. Mycophenolate (MMF). and cyclophosphamide, were used in 7 cases each. Five out of seven patients on MMF achieved complete remission with relapses, and 2 achieved complete remission without relapses, whereas patients on cyclophosphamide experienced therapeutic failure in 3 cases,  complete remission with relapses in 2 cases and  partial remission in 2 cases. The mean follow up duration was 5.1± 3 years. Steroid related complications were present in 10 patients: hypertension in 2 cases, a cataract in one case, osteoporosis in one case, skin stretch marks in one case and growth retardation in 5 cases.

Conclusions:

 short as well as long term outcomes of SSNS are mainly related to steroid response and cumulative dose