Serum neopterin could be used as a marker of the activity of primary nephrotic syndrome but it could not be used to differentiate between steroid-sensitive and steroid-resistant patients.

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Aim: To assess the changes that occurs in serum neopterin levels in children with primary nephrotic syndrome. Methods: Serum neopterin levels were measured by ELISA in 38 children with active primary nephrotic syndrome (group I) and 17 children with primary nephrotic syndrome in remission (group II) and 20 healthy controls. All patients had normal creatinine clearance. Among group I, 28 patients were steroid‐sensitive while 10 patients were steroid‐resistant. Results: Serum neopterin levels were significantly elevated in group I patients (median = 30, 7.2–43.2 nmol/l) compared with group II (median = 6, 2–10 nmol/l, P<0.001) and controls (median = 3.2, range: 0.4–1.8 nmol/l, P<0.001). Group II patients had similar neopterin levels compared with controls (P=0.71). There was a significant positive correlation between serum neopterin levels and the degree of proteinuria in group I patients (r = 0.4, P=0.01). No significant differences in serum neopterin levels were noted between steroid‐sensitive and steroid‐resistant patients (P=0.4). Conclusion: Serum neopterin could be used as a marker of the activity of primary nephrotic syndrome but it could not be used to differentiate between steroid‐sensitive and steroid‐resistant patients.

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