Serum levels of C3 and Factors I and B in minimal change disease

Background: Relapses are an important problem in minimal change disease, which accounts for most of the cases of childhood nephrotic syndrome. Because of defects in the humoral immune system, patients are predisposed to infection in nephrotic syndrome and infection is the most important complication that determines mortality and morbidity. Methods: In this study, serum levels of Factors I and B and C3 were studied to evaluate the relationships between nephrotic syndrome and infection in 17 children with nephrotic syndrome (24-96 months of age) and 10 healthy children (27-84 months of age). Results: Serum levels of Factors I and B were found to be lowered in the active disease group compared with the control group. These Values were lowest for the infection group. Although it was observed that these values increased with steroid treatment, they did not reach normal levels. The parameters in remission were not different from the parameters in the control subjects. The serum level of C3 was found to be high during the active disease state and returned to normal levels during remission. Conclusions: The patients with active minimal change disease had infections such as peritonitis, septicemia and urinary tract infection because of low concentrations of Factors I and B in their sera.