||Miller, Maolynne; Balaraman, V; Shah, Dipak J.|
||Nephrotic syndrome in Jamaican children - a changing pattern ? - abstract|
||West Indian med. j;37(suppl):28, 1988.
||Apresentado em: Commonwealth Caribbean Medical Research 33rd Scientific Meeting, Kingston, Apr. 13-16, 1988.
||A prospective study was undertaken in all children under the age of 12 years presenting for the first time with nephrotic syndrome, in order to determine the causes of nephrotic syndrome and to establish clinico-pathological correlations. Data on 27 patients who were admitted between December 1984 and June 1987 are presented. The investigations included haemoglobin levels, haemoglobin electrophoresis, antistreptolysin O titre, antinuclear factor, C3, VDRL, hepatitis-B-surface-antigen, serum albumin, urea and creatinine levels, urine microscopy, qualitative and quantitative urine protein assay, skin and throat swabs, and renal biopsy in 26/27 patients with features atypical of minimal change nephrotic syndrome. The commonest cause of nephrotic syndrome was mesangial proliferative glomerulonephritis in 30 percent of patients; 26 percent had minimal change nephrotic syndrome. In 59 percent, nephrotic syndrome was thought to be secondary to infection or sickle haemoglobinopathy. Post-streptococcal glomerulonephritis was the commonest suspected infectious cause (79 percent of infections). Hypertension, haematuria, sickle haemoglobinopathy, anaemia, renal failure, hypocomplementaemia, and serological evidence of secondary nephropathy were not features of minimal change nephrotic syndrome. Abnormality of these tests indicated those patients who should have renal biopsy prior to corticosteroid therapy. These data suggest that minimal change nephrotic syndrome is less common than previously suspected. Children with nephrotic syndrome should be thoroughly investigated, including early renal biopsy in those patients presenting with atypical features (AU)|
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