- Prophyiactic antibioitics should be given against possible pneumococcal peritonitis and septicemia MANAGEMENT OF RFLAPSE

Antibiotics - Prophyiactic antibioitics should be given against possible pneumococcal peritonitis and septicemia MANAGEMENT OF RFLAPSE - Relapses may ba associated with bacterial or virul infection especially ot upper respiratory tract. Treatment consist of - (a) Cortcosteroids - for infrequent relapses and if the disease remain sensitive to steroid therapy The drug may be given as a continuous low dosage regime, each patient should be titraed' for the lowest effective dose (usually 5-15 mg/day) The may eliminate the nead for giving ACTH, or altarnate day steroid schedule to prevent the most Important side efect of steroids in children namely growth failure (b) Cyiotoxic drugs -in those who suffer frequent relapses Cyclophosphamide 1. 5-2 .5 mg/kg/day lor 8 weeks: induces stable remission averaging; about 3 years Leucocyte count should ba checked weekly Immediate toxicity ol the drug is negligible but there may be long-term effects II With difluse membranous giomerulonephrltis -Long term outlook is poor Prednisolone 120 mg on alternate days may result in improved renal fusion Dipyndamole, warfarin and cyclophosphamide may also produce significant fall in urine protein, rise in serum albumin and improvement in creations clearance 5 RECURRENT HEMATURIA - syndrome dominated by epsiodes of macroscopic hematuriria, at times associated with loin pain and wtth landency to axacerbations following viral uppar respiratory infection or strenuous exercise it most