Online ISSN: 2515-8260

Clinical Spectrum of Infections in Chidlren with Nephrotic Syndrome

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Pankaj Bhansali1 , Anjali Kale2 , Ajay Kale3 , Nitin Adhane4

Abstract

The incidence of Nephrotic Syndrome is 2-7 cases per 1, 00,000 children per year and prevalence is nearly 16 cases per 1,00,000 . Various infections are considered as most important complications of Nephrotic Syndrome associated with high mortality. Loss of complement factors in urine is one of the major factors in etiopathogenesis of infections. Acute Renal Failure was also described as one of the complications of Nephrotic Syndrome. The present study was carried out to study the incidence and severity of infections in Nephrotic Syndrome with respect to various parameters like the age of patients, number of relapses, duration of disease and mortality. Methods: The present descriptive observational study was conducted in indoor (IPD) and outdoor (OPD) patients in the pediatric department of tertiary care center amongst 82 Nephrotic syndrome patients visiting for various infectious complications from August 2013 to August 2015. Results: Maximum incidence was found in the age of 1-3 years (37%) and male predominance (61%) was seen. Commonest symptom was generalised swelling/facial puffiness (92%), followed by fever (58%), cough (48%). Anasarca was commonest sign (92%), followed by pallor (39%), Scrotal/Vulval edema (22%). 31% were infrequent relapsers and 22% were frequent relpasers. On Ultrasonography, ascites was the commonest finding in 42% of patients and on Chest radiographs, perihilar opacities were seen in 40% of patients. 49% of patients had respiratory tract infections and 34% of patients had Urinary Tract Infections. Conclusions: From our study we concluded that infections are found to be common complication of Nephrotic Syndrome amongst of which respiratory tract infection appears to be the commonest infection. While Serum Albumin and Serum Immunoglobulin levels are considerably low while serum cholesterol level is considerably high in severe infections requiring hospitalization.

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