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Varicella in Nephrotic Syndrome — RACP Paediatrics MCQ

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HardNephrologyVaricella in Nephrotic SyndromeRACP Paediatrics

A 3-year-old boy with nephrotic syndrome in remission develops varicella. He is currently on alternate-day prednisolone 0.5 mg/kg. What is the recommended approach to his steroid therapy during the varicella infection?

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Correct answer: D — Hold prednisolone during active varicella if possible and give oral aciclovir

Varicella in an immunosuppressed child (on corticosteroids) can be severe and potentially fatal. Prednisolone should be held or reduced during active varicella infection if possible, and oral aciclovir (or IV aciclovir if severe) should be commenced promptly. The child should be monitored closely for complications. Varicella vaccination should be given when the child is off immunosuppressive therapy.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Nephrotic Syndrome