الفهرس 
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Abstract
Summary
Nephrotic syndrome is one of the most common kidney diseases seen in children. It is a disorder characterized by severe proteinuria , hypoproteinemia , hyperlipidemia and generalized edema resulting from alterations of permeability at the glomerular capillary wall . MCD is by far the most common cause of nephrotic syndrome in children. It accounts for approximately 80-90% of cases.
Selenium (Se) is a crucial trace element for proper health and development of human as well as other mammals. This micronutrient is best known for its peculiar biological roles in redox balance and might be considered a promising chemopreventive factor against many tumors. It plays a role in anti -inflammatory and antiviral activities, prevention heart diseases, and in delaying the progression of neurodegenerative diseases as well as AIDS.
Iron is a mineral that is an essential component of hemoglobin, an erythrocyte (red blood cell) protein that transfers oxygen from the lungs to the tissues. As a component of myoglobin, another protein that provides oxygen, iron supports muscle metabolism and healthy connective tissue . Iron is also necessary for physical growth, neurological development, cellular functioning, and synthesis of some hormone.
Another important trace element present in the body is Mn. It participates in a lot of enzymatic reactions. This element acts as an essential component of various metalloenzymes and as an activator for some metal-enzyme complexes.
This study aimed to assess Se, Mn and iron serum levels in 135 children divided into 2 groups, group I included 90 pediatric patients with nephrotic syndrome who were already diagnosed and were attending the pediatric Nephrology Clinic in Beni suef University Hospital And group II included 45 healthy children.
There were no significant differences between patients and controls as regarding age.
male sex was predominant in patients compared to controls with a male/ female ratio 2:1.
serum selenium level were significantly lower in patients than control
with mean(24.05 ± 10.741)( 31.555± 28.549) respectively with p value(.029).
serum Iron levels were significantly lower in patients than controls with mean (83.53± 34.779) (106.11± 23.930) respectively with p value(<.001).
also, selenium levels were significantly lower in relapsing patients than patients in remission (20.53 ± 10.76 versus 27.00 ± 9.89) respectively (p; 0.004), and iron levels were significantly lower in relapsing patients than patients in remission (73.75 ± 32.25 versus 91.71 ± 35.01) respectively (p; 0.014).
Serum Mn shows no significant difference between patients and healthy children with mean (88.544 ± 9.080) (85.02 ± 13.119) respectively with p value(.071), while manganese levels were significantly higher in relapsing patients than patients in remission (97.00 ± 11.25 versus 88.16 ± 6.85) respectively (p; <.001).
there were significant negative correlations between PCR and both iron (r; -.372-* ) (p; 0.036 ) and selenium (r; -.361-* ) (p; .047) levels while PCR was positively correlated to serum manganese levels (r; .380)(p; .024).
There was positive correlation between selenium and iron (r=.248*) (p=.018), while there was non-significant correlation between manganese and both selenium and iron.
In coclusion our data show that the plasma levels of Iron and selenium in children with NS were lower than in healthy children, Furthermore, the levels were significantly lower during disease activity and the levels were inversely correlated to the degree of proteinuria. Mn levels were significantly higher during proteinuria and positively correlated to PCR levels.