Presentation
Among MesPGN, 13 (48.1%) patients present Table 3. [sjkdt.org]
Uses the same consistent, step-by-step presentation in every chapter: History, Physical Examination, Diagnosis (including laboratory tests), Imaging, Diagnosis, and Treatment. [books.google.com]
Presentation Symptoms In children, facial swelling is a common presenting feature, with periorbital oedema often being the first evidence that something is wrong; oedema may progress to involve the whole body. [patient.info]
[…] with NS. 1 If these tests are negative, it is recommended that the patient be followed carefully for the presentation of a malignancy for the next 15 months and receive routine care thereafter. [uspharmacist.com]
Although the presentation is similar to that of FN, diffuse mesangial sclerosis (DMS) can present later up to 4 years of age. It presents with unremitting NS within the first 9 months of life usually. [frontiersin.org]
Entire Body System
- Asymptomatic
Asymptomatic intracardiac thrombus in steroid-sensitive nephrotic syndrome. Pediatr Nephrol. 2002; 17 (4): 287-9[ DOI ][ PubMed ] [comprped.com]
The ocular form is often found in adults, who show corneal tears and photophobia, but are otherwise asymptomatic. Early detection of the disease can significantly improve prognosis. [centogene.com]
Membranoproliferative glomerulonephritis - primarily affects children and young adults; presents with nephrotic or nephritic syndrome, or with asymptomatic renal disease [ 7 ]. [patient.info]
The rest continue to have protein in the urine, as either the nephrotic syndrome or the asymptomatic proteinuria and hematuria syndrome. Congenital and infantile nephrotic syndrome These rare disorders are inherited. [msdmanuals.com]
Fifth, children with enteroviral infections can be asymptomatic or carriage. Witsø et al. [ 40 ] reported that human enterovirus was detected in the stool of 51.3% healthy infants. [journals.plos.org]
- Fever
You’ll find clear guidance on exactly what to consider and how to proceed when faced with a host of common symptoms such as cough, fever, headache, chest pain, gait disturbances, and many more. [books.google.com]
Persistent severe cough with fever or severe headache. Chicken pox or measles. Source: Kidney Education Foundation [vikaspedia.in]
Any child with nephrotic syndrome and a fever must be thought of as having an infection until proven otherwise, since they are at high risk for sepsis, similar to splenectomy patients. [hawaii.edu]
You should seek immediate medical advice if: your child has come into contact with someone who has chickenpox or measles and your doctor has told you that your child is not immune to these illnesses your child is unwell or has a fever your child has diarrhoea [nhs.uk]
Educate the parents Always counsel parents and patients to seek medical attention if the child develops abdominal pain or fever, or appears ill. [mdmag.com]
Musculoskeletal
- Long Arm
The CNF gene has been localised to the long arm of chromosome 19 4. See also nephrotic syndrome Promoted articles (advertising) [radiopaedia.org]
The CNF gene has been localised to the long arm of chromosome 19, but the pathogenesis remains unclear. Historically, all CNF patients died, usually within the first 6 months of life. [link.springer.com]
Genet. (1999) [ Pubmed ] Congenital nephrotic syndrome of the Finnish type maps to the long arm of chromosome 19. Kestilä, M., Männikkö, M., Holmberg, C., Gyapay, G., Weissenbach, J., Savolainen, E.R., Peltonen, L., Tryggvason, K. Am. J. Hum. [wikigenes.org]
The gene for Finnish nephropathy (FN) is NPHS1 mapped to the long arm of chromosome 19 (19q13.1) that codes for nephrin ( 7, 11, 12 ). Several nephrin mutations have now been identified. [frontiersin.org]
Urogenital
- Kidney Failure
failure Your GN may be so advanced that you develop kidney failure. [healthline.com]
About 10 to 30% develop progressive kidney failure. Relapses may respond to cyclophosphamide. [msdmanuals.com]
Acute kidney failure. Available online at http://www.mayoclinic.com/health/kidney-failure/DS00280. Accessed March 2014. Mayo Clinic. Nephrotic syndrome. [labtestsonline.it]
Majority of children with minima change disease respond very well to steroids and there is no risk of developing chronic kidney failure. [vikaspedia.in]
Congenital nephrotic syndrome is a kidney condition that begins in infancy and typically leads to irreversible kidney failure (end-stage renal disease) by early childhood. [ghr.nlm.nih.gov]
- Renal Insufficiency
Hypertension, mild renal insufficiency, hypervolemia, and steroid resistance with chronic glomerulonephritis are seen histologically. This form appears volume overloaded from impaired renal sodium excretion. [annals.org]
Risk factors for progression to end-stage renal disease (ESRD) associated with MN include male gender, poorly controlled hypertension, renal insufficiency, and heavy proteinuria. [uspharmacist.com]
Renal ultrasonography may identify renal venous thrombosis if suggestive features, such as flank pain, hematuria, or acute renal failure, are present. [aafp.org]
Light microscopy of the renal biopsies was consistent with the Finnish type of congenital nephrosis in most patients (83%). Chronic renal insufficiency developed in 17, and five of them needed chronic peritoneal dialysis. [cags.org.ae]
These would include an older age at presentation (>12 years), hypertension, an 'active' urine sediment (many RBC's or RBC casts), or renal insufficiency. [clinicaladvisor.com]
- Oliguria
The most common symptoms were oliguria (92%) and edema (86.2%) followed by hematuria (dark urine) (72.4%) and hypertension (35.6%). MPGN was the most common histological type of adult NS in Rangpur. [sjkdt.org]
The signs include cold hands and feet, delayed capillary filling, oliguria, and tachycardia. Hypotension is a late feature. [emedicine.medscape.com]
Renal cysts in children with ADPKD have been associated with wide clinical spectra, ranging from totally asymptomatic patients to those who present as newborns with massive renal enlargement, hypertension, oliguria and pulmonary hypoplasia 8. [centogene.com]
Actual urinary complaints such as haematuria or oliguria are uncommon, though these are seen commonly in nephritic syndrome. [en.wikipedia.org]
Neurologic
- Seizure
Hereditary cerebral hemorrhage with amyloidosis, Iowa type Hereditary cerebral hemorrhage with amyloidosis, Italian type Hereditary cerebral hemorrhage with amyloidosis, Piedmont type Large congenital melanocytic nevus Acute encephalopathy with biphasic seizures [csbg.cnb.csic.es]
Seizure 3. True/False: A renal biopsy is necessary to confirm the diagnosis of primary idiopathic nephrotic syndrome. 4. The inheritance pattern of primary idiopathic nephrotic syndrome is/are:. .. .. a. Autosomal recessive. .. .. b. [hawaii.edu]
[…] kidney disease type 2, autosomal dominant PKD2 Polycystic liver disease PRKCSH Polycystic ovary syndrome type 1 SULT2A1 Polycystic ovary syndrome type 1 SULT2B1 Precocious puberty, male LHCGR Premature ovarian failure type 1 FMR1 Primary aldosteronism, seizures [centogene.com]
Workup
Acute Kidney Injury Workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/243492-workup#c13. Accessed May 2016. (April 2014) Seaborg E. New Biomarkers Offer Hope for Identifying Acute Kidney Injury Risk. [labtestsonline.it]
There are no established guidelines on the diagnostic workup or management of nephrotic syndrome. [aafp.org]
Patients believed to have other renal diseases should undergo additional diagnostic workup, usually including renal biopsy, and may require alternative management. [mdmag.com]
Treatment
treatment strategies for NS. [books.google.de]
After starting treatment, urine is tested regularly to assess its response to treatment. The absence of protein in urine tests suggests a positive response to treatment. [vikaspedia.in]
Treatment of iSRNS A summary of the treatment response of the remaining 17 children is shown in Table 2 and Table 3. Duration of follow up ranged from 5 months to 6.25years. [panafrican-med-journal.com]
Young children who get treatment usually get better and have no lasting problems. Often treatment is not as successful in older children and adults. [myhealth.alberta.ca]
Prognosis
It is difficult to make broad statements about prognosis or life expectancy because every person is unique. Usually, the symptoms of nephrotic syndrome type I begin at birth or within the first year of life. [thinkgenetic.com]
What is the prognosis? When MPGN is associated with another condition or disease, like any of the ones listed above, it is usually resolved by successfully treating the associated condition or disease. [unckidneycenter.org]
Primary Glomerular Disorders That Can Cause Nephrotic Syndrome Glomerular Disorder Description Prognosis Minimal change disease This mild disease of the glomerulus is more common in children but also affects adults. The prognosis is good. [msdmanuals.com]
Prognosis This is very variable depending on the underlying cause. Congenital nephrotic syndrome usually carries a very poor prognosis. Corticosteroids have reduced the mortality rate in children to around 3% [ 17 ]. [patient.info]
As long as the child continues to respond to steroids, he/she most likely has MCNS and an excellent long term prognosis and renal biopsy is not indicated. [clinicaladvisor.com]
Etiology
Etiology It is caused, in Finnish families as well as in other families, by mutations in the NPHS1 gene, localised to chromosome 19. [orpha.net]
The etiology of minimal change nephrotic syndrome is unknown. [clinicaladvisor.com]
Signs, and Symptoms The etiological basis for the development of NS is damage to renal glomeruli causing proteinuria (primarily albumin), hypoalbuminemia, and thus disorder in fluid homeostasis. [uspharmacist.com]
The etiology of this condition remains largely unknown, but some have postulated an immunologic mechanism. [hawaii.edu]
Epidemiology
Summary Epidemiology This type of nephrotic syndrome is more frequent in Finland (with an incidence of 1 in 8 200 births) but it is also observed in various ethnic groups worldwide. [orpha.net]
Epidemiology Nephrotic syndrome can affect children of any age, from infancy to adolescence, and is most commonly seen among school-aged children and adolescents. [pedsinreview.aappublications.org]
Epidemiology of primary glomerular disease in a French region. Variation according to period and age. Am J Kidney Dis 1996;27:647-51. 15. Wahbeh AM, Ewais MH, Elsharif ME. [sjkdt.org]
According to our review of relevant literature, no epidemiologic study has investigated the incidence of nephrotic syndrome following enteroviral infection. [journals.plos.org]
Pathophysiology
Abstract Studies of 16 adults with nephrotic edema reveal a spectrum of disease, the extremes of which suggest two different pathophysiologic forms. [annals.org]
Pathophysiology The kidney uses a complex filtration system known as the glomerular filtration barrier (GFB). [pedsinreview.aappublications.org]
The underlying pathophysiology of nephrotic syndrome is not completely clear. 4 Although the more intuitive “underfill” mechanism of edema from reduced oncotic pressure caused by marked proteinuria may be the primary mechanism in children with acute [aafp.org]
Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York, NY: McGraw-Hill Inc; 2011:873-890. To comment on this article, contact [email protected] [uspharmacist.com]
Pathophysiology of NS The primary defect in NS is loss of proteins in the kidney. [frontiersin.org]
Prevention
Treatment aims to reverse, slow, or prevent further kidney damage. The treatment you need depends on your age and what health problem is causing nephrotic syndrome. [myhealth.alberta.ca]
Blood thinners such as warfarin (Coumadin) or heparin, may be required to treat or prevent clot formation. [vikaspedia.in]