title: Glucocorticoid receptors expression and histopathological types in children with nephrotic syndrome.
abstract: Abstract Background: Some children with idiopathic nephrotic syndrome (NS) patients fail to respond even when given high dose of steroid. The aim of this study was to assess the GCR expression on the T lymphocytes of children with NS and its relation to the response to steroid and to histopathological type.
  
  
  METHODS
  Forty-six pediatric patients with idiopathic NS and 20 age and sex matched apparently healthy children as controls were included. Flow cytometry was employed to determine the percentage of CD3+/GCR+ cells which then correlated with pattern of steroid response. Renal biopsy was done for steroid-dependent and steroid-resistant cases for determination of the underlying histopathological type.
  
  
  RESULTS
  The mean percentage of T lymphocyte expression of GCRs (CD3+/GCR) was significantly higher in early steroid responders than in late responders and was slightly lower than the controls. There was a significantly lower GCRs expression in steroid-resistant patients in comparison to early responders, late responders and controls. Renal biopsy showed that most cases of late responders were of the focal segmental glomerulosclerosis (FSGS) type. The mean percentage of lymphocyte expression of GCRs was significantly higher in patients with minimal change disease (MCD) compared to patients with FSGS.
  
  
  CONCLUSIONS
  Evaluation of the expression of intracellular GCRs in T lymphocytes at time of diagnosis of NS can predict the response to steroid therapy and can help in determination of the outcome of NS patients regarding future relapses.
authors.affiliation: Clinical Pathology Department, South Egypt Cancer Institute, Assiut University , Assiut , Egypt .
authors.forename: Asmaa M
authors.initials: AM
authors.lastname: Zahran
authors.forename: Sanaa Shaker
authors.initials: SS
authors.lastname: Aly
authors.forename: Khalid I
authors.initials: KI
authors.lastname: Elsayh
authors.forename: Ahlam
authors.initials: A
authors.lastname: Badawy
authors.forename: Yasser
authors.initials: Y
authors.lastname: Gamal
mesh_terms: D016022:Case-Control Studies; D002648:Child; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D011446:Prospective Studies; D011965:Receptors, Glucocorticoid / Q000378:metabolism*; D013601:T-Lymphocytes / Q000378:metabolism*
chemical_list: D005938:Glucocorticoids; D011965:Receptors, Glucocorticoid
keywords: Flow cytometry; glucocorticoid receptors (GCRs); nephrotic syndrome