HLA alleles in frequently relapsing steroid-dependent and -resistant nephrotic syndrome in Egyptian children

The association between HLA class II antigens and childhood primary nephrotic syndrome has been reported in different populations. To investigate this association in Egyptian children, DRB1 alleles were typed by DNA polymerase chain reverse hybridization in 20 frequent relapsers/steroid-dependent and 14 steroid-resistant children with minimal change nephrotic syndrome (MCNS) and 121 unrelated healthy controls from the northern part of Egypt. The strength of the association was expressed as the relative risk (RR) estimated by the odds ratio. The DRBI *07011 allele frequency was significantly higher among patients than controls (78.9% vs. 16%, Pc <0.001). The etiological fraction (EF) was high at 0.75 [RR=20.1, confidence interval (CI)=6.0-66.7]. Similarly, patients with steroid-resistant MCNS had a higher frequency of the DRBI *07011 allele than controls (64.3% vs. 16.5%, P c<0.001). The EF was high at 0.57 (RR=9.6, CI 2.9-31.7). In the whole group of patients the frequency of DRBI *11 alleles was low compared with controls (11.4% vs. 32.2%, P =0.02), but was not significant when P was corrected. In conclusion, the DRBI *07011 allele confers susceptibility to a frequently relapsing and steroid-dependent or steroid-resistant course of childhood MCNS. These patterns of the disease seem to have the same immunogenetic components.