Childhood nephrotic syndrome in Cambodia: an association with gastrointestinal parasites.
OBJECTIVE
To describe childhood nephrotic syndrome (NS) in Cambodia and to evaluate whether initial presentation or relapse is associated with gastrointestinal parasitic infection.


METHODS
We reviewed the records of 112 children with NS. A retrospective cross-sectional study compared 99 stool exams from 63 children with NS with 12 365 stool exams from 9495 controls.


RESULTS
The male-to-female ratio was 1.7; the mean age of presentation was 8.95 years--44% were hypertensive, 44% had microscopic hematuria, 40% had eosinophilia, and 41% had acute renal failure; 92.7% were steroid sensitive, 12.7% were steroid dependent, and 8.9% were frequent relapsers. Peritonitis and death were rare outcomes. Giardia lamblia (OR, 3.62; 95% CI, 2.0 to 6.1), Strongyloides stercoralis (OR, 3.59; 95% CI, 1.3 to 8.2), and Hookworm species (OR, 2.57; 95% CI, 1.0 to 5.5) were more likely to be isolated from the children with NS than the controls.


CONCLUSIONS
The clinical course of childhood NS in Cambodia is similar to the developed world. Differences at presentation included older age and increased prevalence of microscopic hematuria, hypertension, eosinophilia, and acute renal failure. This study demonstrates an association between G lamblia, S stercoralis, and possibly Hookworm species and the onset of NS.
Copelovitch
Lawrence
L
Department of Pediatrics, Angkor Hospital for Children, Samdech Tep Vong Street, Siem Reap, Cambodia. Copelovitch@email.chop.edu.
Sam Ol
Orng
O
Taraquinio
Sarah
S
Chanpheaktra
Ngoun
N
D000818:Animals; D002160:Cambodia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004802:Eosinophilia / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D016829:Giardia lamblia; D005873:Giardiasis / Q000453:epidemiology; D006417:Hematuria / Q000453:epidemiology; D006725:Hookworm Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000453:epidemiology* / Q000469:parasitology*; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000453:epidemiology