Childhood nephrotic syndrome and heavy proteinuria in Taiwan. A retrospective clinicopathologic study.

From April 1981 to November 1987, 347 children with either nephrotic syndrome (NS; 262 cases, 75.5%) or heavy proteinuria (85 cases, 24.5%) were studied to determine the clinicopathologic manifestation of these diseases among Taiwanese children. All of the children were less than 18 years of age and all had undergone renal biopsy. IgM mesangial nephropathy (IgMN; 93 cases, 26.9%) and minimal change nephrotic syndrome (MCNS; 62 cases, 17.8%) are the most frequently found pathologic lesions. The clinical course of MCNS is always responsive to steroids and less relapsive. However, IgMN is characterized by its good initial response to steroids and frequent relapses. As for secondary glomerulonephritis, lupus nephritis has the first position and comprises 18.4% (64 cases) of all cases. Membranous nephropathy associated with hepatitis B antigenemia (HBVMN; 34 cases, 9.8%) has the second position. Most cases of membranous nephropathy in children in Taiwan are HBVMN. The age of peak incidence is around 2-7 years old. Most of them had frequent relapses of NS or persistent heavy proteinuria. Membranoproliferative glomerulonephritis (MPGN) accounts for only 1.2% (4 cases) of all cases, relatively lower than reported elsewhere. The high incidence of IgMN, HBVMN and low incidence of MPGN are probably due to geographic or racial differences in Taiwan with respect to those in other countries.