Idiopathic nephrotic syndrome leads to massive proteinuria, intractable edema, frequent infection, and if unresponsive to steroids, progressive renal insufficiency. The etiology of this disorder is unknown, but there have been several reports in the literature linking food hypersensitivity with idiopathic nephrotic syndrome. The purpose of this study is to determine whether food hypersensitivity plays a pathogenic role in children with steroid-resistant, idiopathic nephrotic syndrome. Sixteen children with this disorder will be compared in a blinded, randomized cross-over trial of an elemental diet for 4 weeks in each arm to determine whether proteinuria can be reduced. Patients will be evaluated for levels of food-specific IgE and IgG antibodies and peripheral blood T cell proliferative responses and cytokine mRNA expression in response to egg and milk antigens.
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