Alopecia Universalis with Frequently Relapsing Nephrotic Syndrome of Infantile Onset: A Rare Presentation

This case report describes a rare presentation of alopecia universalis (AU) associated with frequently relapsing nephrotic syndrome (FRNS) in a 3-year-old girl. The child experienced hair loss from the scalp and eyebrows starting at 2 months of age, followed by symptoms of nephrotic syndrome at 11 months. Despite initial improvement with high-dose corticosteroids, AU recurred and did not respond to subsequent treatments including low-dose corticosteroids, mycophenolate mofetil, and tofacitinib. The case suggests a potential genetic and autoimmune link between AU and FRNS, as the patient's sibling also had nephrotic syndrome. The authors propose that more specific JAK kinase inhibitors may be needed for effective treatment, highlighting the novelty of this pediatric case with a familial history of nephrotic syndrome.