Jiang Ying, Zhang Bi-Li, Wang Wen-Hong
Department of Nephrology, Tianjin Children's Hospital, Tianjin 300134, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Feb;21(2):165-167. doi: 10.7499/j.issn.1008-8830.2019.02.011.
To study the clinical features of nephrotic syndrome (NS) accompanied by eosinophilia in children.
A retrospective analysis was performed for the clinical manifestations, laboratory findings and treatment outcomes of 18 cases of eosinophilia (15 children, 3 of whom also had eosinophilia at the second recurrence) in children with NS.
Of the 18 cases, 16 (89%) had mild eosinophilia, 1 (6%) had moderate eosinophilia, and 1 (6%) had severe eosinophilia. Twelve cases (67%) developed eosinophilia in winter and spring. Nine cases (50%) had infectious diseases: pneumonia (including 2 cases of Mycoplasma pneumonia) in 4 cases, EB virus infection in 3 cases, suspected pinworm infection in 1 case, and Streptococcal infection in 1 case. Five cases (28%) had allergic diseases: urticaria in 2 cases, allergic rhinitis in 2 cases and eczema in 1 case. There was no significant correlation between eosinophil count and the levels of urinary protein, serum albumin and cholesterol (P>0.05). In 8 cases of newly diagnosed NS, urinary protein turned negative within 4 weeks after glucocorticoid treatment. In 10 cases of recurrent NS, urinary protein turned negative in 9 cases after the adjustment of glucocorticoid treatment. In 1 case of recurrent NS (moderate eosinophilia with allergic rhinitis), symptomatic relief and negative urinary protein were achieved after anti-allergic treatment. Glucocorticoid therapy was not administered again in the patient, and the eosinophil count was reduced to a slight increase. The eosinophil counts of the other 17 cases returned to normal.
NS with eosinophilia in children occurs mostly in winter and spring. This disorder is associated with infection or allergic diseases. There was no significant correlation between eosinophil count and the levels of urinary protein, serum albumin and cholesterol.
研究儿童肾病综合征（NS）伴嗜酸性粒细胞增多的临床特征。
对18例NS患儿（15例儿童，其中3例在第二次复发时也有嗜酸性粒细胞增多）的临床表现、实验室检查结果及治疗结局进行回顾性分析。
18例中，16例（89%）为轻度嗜酸性粒细胞增多，1例（6%）为中度嗜酸性粒细胞增多，1例（6%）为重度嗜酸性粒细胞增多。12例（67%）在冬春季节出现嗜酸性粒细胞增多。9例（50%）有感染性疾病：4例患肺炎（包括2例支原体肺炎），3例EB病毒感染，1例疑似蛲虫感染，1例链球菌感染。5例（28%）有过敏性疾病：2例患荨麻疹，2例患过敏性鼻炎，1例患湿疹。嗜酸性粒细胞计数与尿蛋白、血清白蛋白及胆固醇水平之间无显著相关性（P>0.05）。8例新诊断的NS患儿，糖皮质激素治疗后4周内尿蛋白转阴。10例复发的NS患儿，调整糖皮质激素治疗后9例尿蛋白转阴。1例复发的NS患儿（中度嗜酸性粒细胞增多伴过敏性鼻炎），抗过敏治疗后症状缓解且尿蛋白转阴。该患儿未再给予糖皮质激素治疗，嗜酸性粒细胞计数降至轻度升高。其他17例患儿的嗜酸性粒细胞计数恢复正常。
儿童NS伴嗜酸性粒细胞增多多见于冬春季节。这种疾病与感染或过敏性疾病有关。嗜酸性粒细胞计数与尿蛋白、血清白蛋白及胆固醇水平之间无显著相关性。
