Nephrotic syndrome in the second decade of life.

In 22 (13 females, 9 males) of 224 patients presenting with nephrotic syndrome, onset occurred during the second decade of life. Lipoid nephrosis and its variants (nil, focal segmental, or focal global glomerulosclerosis and mesangial proliferative) accounted for the disease in the majority of patients (13 patients). In all with nil change (7 patients) and one of the 4 with mesangial proliferation the disease completely resolved with steroids. Forty-one percent of patients had nephrotic syndrome as the result of other forms of glomerulonephritis: 1 patient had nephrotic syndrome secondary to poststreptococcal glomerulonephritis which resolved spontaneously. Three patients had membranoproliferative glomerulonephritis and developed renal insufficiency. Proteinuria decreased or disappeared in 4 patients with systemic lupus erythematosus. One patient had membranous nephropathy that was steroid resistant. Presenting symptoms and laboratory data failed to separate nil change from the more severe glomerular lesions. Early biopsy for diagnosis is suggested for patients presenting with de novo nephrotic syndrome in the second decade of life.