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Question :
Our Daughter, now 2 and a half, was diagnosed with nephrotic syndrome about 4 months ago. Since, she has not been off of orapred. She has relapsed 3 times now. Is this normal to relapse so often? All that it takes is a cold. Is this something that we should just accept, that because of her age, and being more suseptable to colds, etc., that she is going to continue to relapse? Can being on the orapred so much cause damage to her? We feel overwhelmed because there is no way to "control" it. Do you have any suggestions? Thank you.
Answer
Your daughter seems to be an infection induced frequent relapser. Though steroids are the treament of choice, you have to see that with treatment of infection whether the proteinuria subsides. If yes, then steroids for every relapse is not required. Only if the proteinuria persists inspite of omission of infection, steroids are indicated. If she persists to require chronic steroids, additional agents such as levamisole may be useful to decrease the number of relpase. Consult your pediatric nephrologist for the same.
 
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