Paradoxical Association of Kawasaki Disease in a Child with Steroid-dependent Nephrotic Syndrome

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BSTRACT

Most cases of nephrotic syndrome (NS) in children are idiopathic, with only a small proportion associated with systemic diseases. Kawasaki disease (KD) is a rare cause of secondary NS, and NS is an uncommon renal manifestation of KD. Relapses in NS are often triggered by infections, particularly of the upper respiratory tract, which may also initiate immune activation leading to KD. We report a 4-year-old boy with steroid-dependent nephrotic syndrome (SDNS), in remission on steroids and mycophenolate mofetil (MMF), who presented with relapse associated with KD. This case highlights a rare clinical association and its implications for diagnosis and management.