Clinical profile of children with nephrotic syndrome not on glucorticoid therapy, but presenting with infection
Clinical profile of children with nephrotic syndrome not on glucorticoid therapy, but presenting with infection
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DOI：
10.1111/j.1440-1754.2004.00285.x
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发表时间：
2004-01-01
影响因子：
1.7
通讯作者：
Rath, B
中科院分区：
文献类型：
--
作者：
Alwadhi, RK;Mathew, JL;Rath, B
目的：这是一个前瞻性的，以医院为基础的研究超过一年的时间，检查肾病儿童的临床资料，而不是糖皮质激素治疗，但呈现infection.Methods：68名儿童76次肾病综合征在研究年期间入组。使用临床和调查标准检查他们是否有感染的证据。每天监测儿童的蛋白尿和感染改善情况。感染得到控制后，泼尼松龙治疗开始在那些谁不是已经在remission.Results：在76集，8被排除在分析，因为他们已经开发感染，而他们对糖皮质激素治疗。在60名儿童的其余68次肾病发作中，有57次（83.8%）有感染证据。上呼吸道感染最常见（28.0%），其次是尿路感染（22.8%）、腹膜炎（15.8%）、肺炎（14.0%）、急性侵袭性腹泻（10.5%）和脓胸（5.3%）。与非感染儿童相比，感染儿童的血清白蛋白显著降低，血清胆固醇显著升高。感染的57次发作，缓解发生在9次（15.8%）单独控制感染和糖皮质激素治疗是不需要的。结论：感染是广泛流行的印度儿童肾病综合征的发作，即使当他们不是糖皮质激素治疗。有些孩子可能会进入缓解控制感染。在感染中，上呼吸道和泌尿道感染是最常见的。
Objective: This is a prospective, hospital based study over a period of one year, to examine the clinical profile of nephrotic children not on glucocorticoid therapy, but presenting with infection.Methods: Sixty-eight children with 76 episodes of nephrotic syndrome were enrolled during the study year. They were examined for evidence of infection using clinical and investigative criteria. The children were monitored daily for proteinuria and improvement of infection. After the infection was controlled, prednisolone therapy was started in those who were not already in remission.Results: Of the 76 episodes, eight were excluded from analysis as they had developed infection while they were on glucocorticoid therapy. Of the remaining 68 nephrotic episodes in 60 children, there was evidence of infection in 57 episodes (83.8%). Upper respiratory infection was the most common (28.0%) followed by urinary tract infection (22.8%), peritonitis (15.8%), pneumonia (14.0%), acute invasive diarrhoea (10.5%) and empyema (5.3%). Children with infection had significantly lower serum albumin and higher serum cholesterol compared to non-infected children. Of the 57 episodes with infection, remission occurred with control of infection alone in nine episodes (15.8%) and glucocorticoid therapy was not required.Conclusion: Infection is widely prevalent among Indian children presenting with episodes of nephrotic syndrome, even when they are not on glucocorticoid therapy. Some children may go into remission by control of infection alone. Among the infections, upper respiratory and urinary tract infections are the most common.