Nephrotic Syndrome in Kids

When you see a child with proteinuria, edema, and high cholesterol levels (all which together point toward nephrotic syndrome), you think minimal change disease.  We've all been taught that you treat this empirically with corticosteroids and that it will resolve.  Until recently, the etiology was thought to be idiopathic.  Now we know that it is a T cell mediated problem and can be caused by NSAIDs, lithium, allergic reaction following a bee sting, and graft vs host disease.  Even knowing all this...the treatment is still high dose corticosteroids.