Leukocyte nitroblue tetrazolium test and chemotaxis in children with nephrotic syndrome and nephritis.

Patients with nephrotic syndrome have an increased incidence of infection; the cause of this is unknown. It is recognized that neutrophils play an important role in the protection of the body against bacteria. In an attempt to evaluate the function of neutrophils in various categories of nephritis, and that function's relationship in response to steroid therapy in the idiopathic nephrotic syndrome, a study using peripheral blood neutrophils on nitroblue tetrazolium test (NBT) and chemotaxis was performed in 62 children suffering from nephritis during its acute phase and remission. These patients included minimal change nephrotic syndrome (MCNS), 9 cases; focal segmental glomerular sclerosis (FGS), 3 cases; mesangial cell proliferative nephropathy (MesPGN), 23 cases; hepatitis B antigenemia associated with membranous glomerulonephropathy (HBSMGN), 4 cases; poststreptococcal glomerulonephritis (AGN), 20 cases and chronic glomerulonephritis (CGN), 3 cases. The NBT reduction levels were significantly increased in the MCNS and AGN groups during the acute nephrotic or nephritic phase and returned to normal range in remission. The chemotactic index significantly decreased in the MCNS and significantly increased in the MesPGN cases; in the remission stage, they returned to normal range. All cases of MesPGN in this study were nephrotic syndrome with frequent relapse or were steroid non-responsive. These results suggest that, except for MCNS, the higher incidence of infection in nephrotic syndrome has no relation to neutrophil chemotaxis and NBT in various categories of nephritis. However, the chemotactic index may serve as one of the parameters between steroid responsive and non-responsive nephrotic syndromes.