Abdominal Pain and Vomiting in a Boy With Nephrotic Syndrome.

11:15 EDT 30th October 2014 | BioPortfolio

Summary of "Abdominal Pain and Vomiting in a Boy With Nephrotic Syndrome."

Although nephrotic crisis, i.e. acute hypovolemia in the course of nephrotic syndrome, is not uncommon in children, this complication is seldom mentioned in literature. We report a 4-year old boy with a relapse of steroid-sensitive nephrotic syndrome precipitated by a viral respiratory infection, who presented with abdominal pain, vomiting, diarrhea and hypovolemic shock 15 hours after the initial hospital visit. Serum albumin had decreased from 1.5 to 0.6 g/dL, hemoglobin had risen from 16.1 to 19.5 g/dL and urine albumin concentration was 6.5 g/dL. He responded promptly to fluid resuscitation with normal saline and albumin infusion. A bacterial infection was excluded and a diagnosis of nephrotic crisis made based on the combination of a rapid drop in serum albumin and hemoconcentration. Acute loss of the colloid-osmotic pressure gradient at the capillary level caused fluid leakage into the interstitium. Together with fluid losses from intestinal ischemia, this led to acute hypovolemia.

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This article was published in the following journal.

Name: Clinical pediatrics
ISSN: 1938-2707
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