Background: Childhood nephrotic syndrome (MCNS) has often been associated with allergic symptoms. The association between atopy and nephrotic syndrome may have a causal or non-causal basis. Objectives: To assess the topic state of patients with SRNS. Methods: Serum ECP levels were measured by chemiluminescent enzyme immune metric assay and skin prick tests were done in 32 children with SRNS and 10 age-and sex matched healthy children without evidence of atopy. Out of the nephrotic patients, 19 children had active disease (Group I) and 13 were in remission (Group II). Among group I, 7 children were frequent relapsers (FR) while 12 were infrequent relapsers (IR) or non-relapsers (NR). Results: We found that 37.5% of our patients had positive skin prick tests. Serum ECP levels were elevated in group I patients [median = 25.3 & Interquartile range (IQR) = 13.8-33.6 ng/ml] and group II patients [median = 14.2 & IQR = 12.0-20.2 ng/ml] compared to controls [median = 9.1 & IQR = 7.2-13.5 ng/ml], p ˂0.0001 & 0.0026 respectively]. Similarly, patients with negative skin pricks tests in group I and group II had higher ECP levels compared to controls (p = 0.007 & 0.07 respectively). Among group I, ECP levels were higher in patients with positive skin pricks tests to those with negative tests (p ˂0.0001) and in FR compared to IR and NR (P = 0.05). Moreover, there was an association between the development  of frequent relapses and positively of skin prick tests (Fisher′s Exact= 0.07 relative risk = 6.4 & confidence interval = 1.0-41.2). Conclusions: Serum ECP levels are elevated in children with active SRNS. ECP could be considered as one of the neutralizing cations involved in the pathogenesis of proteinuria in these patients. Atopy could be assumed as a risk factor for the development of frequent relapses, so the value of a course of non-steroidal anti-inflammatory drug (as ketotifen) in frequently relapsing nephrotic children should be evaluated.