| Clinical Analysis of Children with Nephrotic Syndrome. |
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Ki Young Cheong, Keon Su Rhee |
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Department of Pediatrics, Chungnam National University, Taejeon, Korea |
| 소아 신증후군에 대한 임상적 고찰 |
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정기영, 이건수 |
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충남대학교 의과대학 소아과학교실 |
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Received: 28 December 1989 • Accepted: 20 March 1990 |
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| Abstract |
A clinical analysis was made on 51 cases with nephrotic syndrome who were admitted to Pediatric
Department of Chung Nam National University Hospital from January 1st, 1984 to December 31st,
1988. Clinical manifestation, response to the inital continuous steroid therapy, relapsing patterns,
factors affecting response to steroid therapy, pathologic findings and difference in laboratory findings
between relapser and nonrelapser were evaluated.
Results
were as follows;
1) Among 51 cases, male was 37 cases (72.5%), female was 14 cases (27.5%) and male to female
ratio was about 3:1. The most prevalent age group was 5-9 years (Table 1, Fig 1).
2) Gastrointestinal symptoms were noted in 23 cases (45.1%), pretibial pitting edema was noted in
all cases and generalized edema was noted in 43 cases (84.3%)(Table 2).
3) Diuresis after steroid therapy was observed in 46 cases (89.7%) and in 36 cases, diuresis was
noted within one week (Table 3). In 30 cases (58.8%), proteinuria disappeared and in most patients,
25 cases (49.0%), proteinuria disappeared within 2 weeks after steroid therapy (Table 3).
4) Complete remission was observed in 30 cases (58.8%)，incomplete remission was observed in 15
cases (29.4%) and remaining 6 cases (11.8%) were resistant to steroid therapy (Table 4).
5) Hematuria, hypertension and azotemia were observed in 12 cases (23.5%), 7 cases (13.75%) and
17 cases (33.3%) jrespectively. Nephritic symptoms were more frequently observed in partial respon-
der and nonresponder but in complete remission group, nephritic symptoms were observed in 26.7%,
10.0% and 33.3% (Table 6,7,8).
6) U pper respi r a tor y tract infection was frequently associated with relapse (Table 9). In most cases,
duration of follow up was less than one year (Table 10). Thirty one of 51 cases (60.9%) relapsed
during follow up and most relapsing patient experienced once or twice (Table 11).
7) Renal biopsies were done in 21 cases and primary nephrotic syndrome was 17 cases, pathologic
findings were as follows; MCNS 7 cases (33.3%), mesangial proliferative gl이nerulonephritis 3 cases
(14.2%), FSGS 5 cases (23.8%), MPGN 2 cases (9.5%)(Table 12).
8) Difference in laboratory findings between relapser and nonrelapser were evaluated with Student’s
T test, but there were no statistically significant difference in s-total protein, s-albumin, s-cholesterol
and 24 hours urine total protein. Serum IgG was decreased in both group, s-IgA was in normal range
and s-IgM was slightly decreased in both group but significance was not noted. In complement system,
C3 was normal in both group but C4 was higher in nonrelapsing patients than relapsers and it was
statistically significant(p < 0.011)(Table 13,14). |
| Key Words:
Nephrotic syndrome, Steroid therapy |
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