Text Box: DIFFERENT PATHOLOGICAL PATTERNS OF CHILDHOOD NEPHROTIC SYNDROME IN DEVELOPING COUNTRIES Elidrissy A.T.H. King Abdulaziz Hospital & Oncology Center, Jeddah, KSA Reported renal biopsy, findings in childhood nephrotic syndrome in developing countries were reviewed. The objective was to find common grounds for management of this disease. It was observed that the pathological patterns were different on comparing the Arab to the African countries. The African Arabs were similar to other African countries making environmental factors to be considered as playing a major role. The increased frequency of mesangio proliferative glomerulonephritis (MBGN) in middle east cases is significant and is unique warranting the need for further studies. The minimal change cases were lower than what was reported by ISKDC, but the biopsied cases were selected in contrast to the ISKDC cases. All the cases with membranous nephropathy were hepatitis B (HBV) positive giving strong suggestion for the HBV as a causative agent in this pathological finding. This is further strengthened by high percentage of membranous nephropathy in these series. HBV screening need to be included in the work up of nephrotic syndrome specially the HBV positive cases showed a poor prognosis in some communities and good in others. On dividing the pathological diagnosis according to the response to steriods, the MPGN is divided almost equally among the three groups namely steriod resistant, dependent and frequent relapser, whereas the minimal change pathology forms less than 10% of resistant group, 35% of the dependent group and 20% of the frequent relapsing group. The controversy of the pathological findings in childhood nephrotic syndrome in these countries make it necessary to make a study among non selected cases similar to ISKDC study. 2493