Steroid-Dependent Nephrotic Syndrome in a Child After an Allogeneic Bone Marrow Transplant: A Case Report

Nephrotic syndrome is a frequently encountered disease in children. It is mostly responsive to high-dose steroids, with some requiring steroid-sparing immunosuppressive regimens, or further, a renal biopsy if resistant to steroid therapy. However, nephrotic syndrome in children post-allogeneic bone marrow transplant is rarely encountered. The authors report here a child who developed nephrotic syndrome post-allogeneic bone marrow transplant for β-thalassaemia major, with the suspicion of graft-versus-host disease that was difficult-to-treat, who had frequent relapses with multiple hospital admissions, and prolonged treatment course. For the last 5 years, the disease has been in remission, on a low dose of prednisolone and mycophenolate mofetil-based maintenance immunosuppressive treatment.