Caso contributivo
Un bambino assopito con sindrome nefrosica
An asleep child with nephrotic syndrome
Martino Marsciani, Augusto Biasini
UO di Pediatria e Terapia Intensiva Pediatrica-Neonatale, Ospedale M. Bufalini, Cesena, AUSL della Romagna
Aprile 2014
Abstract
Idiopathic nephrotic syndrome is a disease characterized by proteinuria over 40 mg/m2/hr, hypoalbuminemia, edema and hyperlipemia. Its incidence is 2-3 cases per 100,000 children per year. The response to steroid therapy is expected in 90% of children in the first 5 week of treatment. Thromboembolic events represent a rare complication during childhood and their incidence is 2-3%. The vagueness of the symptoms may the diagnosis rather difficult. We report a case with this serious complication appeared few days after clinical remission.
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Bibliografia
- Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet 2003;362(9384):629-39.
- Niaudet P. Long-term outcome of children with steroid-sensitive idiopathic nephrotic syndrome. Clin J Am Soc Nephrol 2009;4(10):1547-8.
- Hodson EM, Willis NS, Craig JC. Corticosteroid therapy for nephrotic syndrome in children. Cochrane Database Syst Rev 2007;(4):CD001533.
- Montini G, Pasini A. Studio osservazionale retrospettivo sulla terapia con prednisone del primo episodio di Sindrome Nefrosica Idiopatica (SNI) in età pediatrica: appropriatezza terapeutica ed effetti a medio e lungo termine. Protocollo SN-05-2010 pagg. 1-8.
- Vivarelli M, Moscaritolo E, Tsalkidis A, Massella L, Emma F. Time for initial response to steroids is a major prognostic factor in idiopathic nephrotic syndrome. J Pediatr 2010;156(6):965-71.
- Fakhouri F, Bocquet N, Taupin P, et al. Steroid-sensitive nephrotic syndrome: from childhood to adulthood. Am J Kidney Dis 2003;41(3):550-7.
- Hodson E. The management of idiopathic nephrotic syndrome in children. Paediatr Drugs 2003;5:335-49.
- Yang GF, Schoepf UJ, Zhu H, Lu GM, Gray JC 3rd, Zhang LJ. Thromboembolic complications in nephrotic syndrome:imaging spectrum. Acta Radiol 2012;53(10):1186-94.
- Kerlin BA, Ayoob R, Smoyer WE. Epidemiology and Pathophysiology of Nephrotic Syndrome–Associated Thromboembolic Disease. Clin J Am Soc Nephrol 2012;7(3):513-20.
- Singhal R, Brimble KS. Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management. Thromb Res 2006;118(3):397-407.
- Fluss J, Geary D, deVeber G. Cerebral sinovenous thrombosis and idiopathic nephritic syndrome in childhood: report of four new cases and review of the literature. Eur J Pediatr 2006;165:709-16.
- Loscalzo J. Venous thrombosis in the nephrotic syndrome. N Engl J Med 2013;368:956-8.
- Niaudet P. Complications of idiopathic nephrotic syndrome in children. Mattoo TK, Kim MS Ed. UpToDate June 11, 2012.
- Monagle P, Chan A, Massicotte P, Chalmers E, Michelson AD. Antithrombotic therapy in children: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):645S-687S.
- Sarasin FP, Schifferli JA. Prophylactic oral anticoagulation in nephrotic patients with idiopathic membranous nephropathy. Kidney Int 1994;45:578-85.
- Niaudet P. Steroid-sensitive idiopathic nephrotic syndrome in children. In: Avner ED, Harmon WE, Niaudet P Eds. Pediatric nephrology 5th edn. Lippincott Williams & Wilkins Philadelphia, 2004. pp 543–4
- Andrew M, Brooker LA. Hemostatic complications in renal disorders of the young. Pediatr Nephrol 1996;10:88-99.
- Palcoux JB, Gaspard F, Campagne D. Cerebral sinus thrombosis in a child with steroid-resistant nephrotic syndrome. Pediatr Nephrol 2003;18:610-61.
