Childhood nephrotic syndrome is a prevalent renal disorder characterized by generalized edema due to hypoalbuminemia from heavy proteinuria. This syndrome can be classified as primary or secondary, with the majority of cases being primary. Current management primarily relies on corticosteroids, but issues such as frequent relapses and steroid dependency necessitate alternative therapies. Recent approaches include the use of levamisole and mycophenolate mofetil, alongside the resurgence of intramuscular ACTH (synacthen) as a treatment option.This book describes the treatment of frequently relapsing steroid-dependent nephrotic syndrome, successfully, with a novel combination of intramuscular synacthen and mycophenolate mofetil. This regimen effectively reduced the required dosage of steroids while minimizing associated adverse effects, particularly psychiatric symptoms. The findings underscore the potential for innovative therapeutic strategies in managing challenging cases of childhood nephrotic syndrome.
