Abstract Ref Number = APCP1094
NEPHROTIC SYNDROME WITH FOCAL SEGMENTAL GLOMERULOSCLEROSIS
Nur Liya Abd Kadir,Syarifuddin Rauf
Departement of Child Health Faculty of Medicine Hasanuddin University Dr Wahidin Sudirohusodo Hospital Makassar Indonesia Departement of child Health Faculty of Medicine Hasanuddin University Dr Wahidin Sudirohusodo Hospital Makassar Indonesia
Background : Nephrotic syndrome (NS) is characterized by proteinuria (>50 mg/kg/24 hr), edema, hypoalbuminemia (<2.5 g/dl), and hypercholesterolemia. In hystopatology pattern of Nephrotic syndrome idhiopatic, about 20% are Focal Segmental Glomerulosclerosis (FSGS) in pediatric nephrotic syndrome. Approximately 80% of nephrotic syndrome with FSGS is steroid resistant.
Case Presentation Summary : A 13 years and 1 month old girls admitted to the hospital due to swelling on the eyelid since 3 months before. She was given prednisone for 8 weeks before admitted. Physical examination revealed edema on the face, blood pressure 140/100 mmHg, wasting, and Body weight/height was 62,79 % according to the center for Disease Control (CDC 2000). Laboratory data revealed serum albumin 3.2 g/dl, serum cholesterol 300 mg/dl, and urinary albumin 3+, Esbach’s test 0.5 g/24 hr, kidney biopsy result is Nephrotic syndrome with focal segmental sclerosis appearance. The patient was treated with methylprednisolone, antihypertensive, low protein diet 1.5-2 g/kg/day, reduction of salt intake (1-2 g/day), and malnutrition management.
Learning Points/Discussion : • FSGS is the second most common histopathologic lesion of nephrotic syndrome idiophatic after minimal change. • Clinical manifestations of FSGS in this patient are eyelid edema and face, hypoalbuminemia, hypercholesterolemia, proteinuria, hypertension and kidney biopsy result was nephrotic syndrome with focal segmental sclerosis appearance, and worsening by malnutrition. • Prognosis is dubia if there is no remission in the treatment period.
Keywords: Nephrotic syndrome Focal Segmental Glomerulosclerosis Kidney biopsy