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Case Studies | Medicine Science | Albania | Volume 12 Issue 4, April 2023

Case Report on Steroid - Resistant Nephrotic Syndrome in Children

Ana Doku | Diamant Shtiza ^[8] | Marinela Lena | Migena Kaza

Abstract: Nephrotic syndrome (NS) is a glomerular disorder typically characterized by gross proteinuria, hypoalbuminemia, hyperlipidemia, and peripheral edema. We report the case of a 5 - year - old male child weighing 18 kg with a 1 - week history of swelling around the eyes and generalized body swelling. He had a history of upper respiratory tract infection two weeks before hospitalization, fever, cough and frequent urination and oliguria. Examination revealed bilateral pedal edema (pitting type). Laboratory investigations showed protein in urine, reduced serum albumin, reduced serum protein with elevated lipid levels. Calcium and magnesium serum levels slightlybelow normal range. It was also performed a kidney biopsy which further confirmed diagnosis of steroid - resistant nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS). The patient was mainly treated with furosemide, prednisone, ramipril, intravenous albumin, omeprazole, ca gluconate 10% solution, kcl 7.5% solution, antibiotics. After8weeks on steroids, proteinuria, edema and hyperlipidemia persisted. Then biopsy was performed which resulted in FSGS (focal segmental glomerulosclerosis) and cyclosporine was added to the initial therapy. After three months of treatment with cyclosporine there was remission of the symptoms and improvement of laboratory findings.

Keywords: steroid - resistant nephrotic syndrome, proteinuria, hyperlipidemia, edema and hypoalbuminemia, FSGS, prednisone, cyclosporine

Edition: Volume 12 Issue 4, April 2023,

Pages: 595 - 597