A 5-year-old boy presents with his third relapse of nephrotic syndrome within 6 months. He has been responding to corticosteroids each time (proteinuria clears within 4 weeks). He is currently on alternate-day prednisolone for maintenance. This pattern is classified as:

• A Steroid-resistant nephrotic syndrome
• B Steroid-dependent nephrotic syndrome
• C Frequently relapsing nephrotic syndrome ✓
• D Late non-responder nephrotic syndrome

Explanation

Frequently relapsing nephrotic syndrome is defined as ≥2 relapses within 6 months of initial response, or ≥4 relapses within any 12-month period. Steroid-dependent nephrotic syndrome is defined as two consecutive relapses occurring DURING steroid tapering/alternate-day therapy or within 14 days of stopping steroids. Steroid-resistant nephrotic syndrome is failure to achieve remission after 8 weeks of daily prednisolone. Since this child has relapsed three times in 6 months but each relapse responds to corticosteroids, the pattern is frequently relapsing. Management includes cyclosporine, mycophenolate, or levamisole to minimize cumulative steroid dose.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.