In a toddler with MCNS, which finding indicates an early relapse after corticosteroid treatment?

• A. Albuminuria
• B. Decreased serum albumin
• C. Hyperlipidemia
• D. Hyponatremia

Answer: (A)

Relapse in this condition is best detected by the return of protein loss in the urine. When steroids put the nephrotic syndrome into remission, urinary protein disappears; if relapse happens, the glomerular leak resumes, and albumin begins to spill into the urine again. Serum albumin may then fall as protein loss continues, and other features like hyperlipidemia can appear, but the earliest sign of relapse is albuminuria.