Late recurrence of minimal lesion nephrotic syndrome

Nephrotic syndrome recurred in 16 patients who had been free of the disease of an interval of 4 to 25 years. Their initial illness began in childhood and responsed to adrenocorticosteroid therapy; in 10 patients it was associated with few changes on light microscopic examination of kidney biopsy specimens. The late recurrence also responded to steroids, and in only 1 patient did low grade proteinuria persist after treatment. Renal biopsy specimens taken from 8 patients during late recurrence showed minimal-change nephrotic syndrome in 7 and focal segmental glomerulosclerosis in 1. Renal function remained normal in all patients. The late recurrence of minimal-change nephrotic syndrome has most of the features of that syndrome seen in the more typical childhood age group and should be managed similarly.