Does Zika virus infection induce prolonged remissions in children with idiopathic nephrotic syndrome?

Background: Zika is an emerging mosquito-borne flavivirus. We report two pediatric patients diagnosed with idiopathic nephrotic syndrome who achieved complete remission of the disease after suffering Zika virus (ZIKV) infection.

Case diagnosis/treatment: The first patient was a young girl aged 2.5 years with steroid-dependent nephrotic syndrome who was subsequently diagnosed with ZIKV infection. Following the infection, the steroid dose could be reduced until complete withdrawal. The patient persists in complete remission. The second patient was a steroid-resistant boy aged 7 years who was scheduled for a renal biopsy when he was diagnosed with ZIKV infection. A week after the recovery phase of the acute rash, proteinuria was noted to be gradually falling. Today, 12 months later, he is in complete remission of the disease.

Conclusions: We are aware that the improvement observed in our two patients after ZIKV infection may be be random. However, it is also possible that future studies will discover that ZIKV infection has some effect on the cellular immune system similar to that of measles infection.