A RETROSPECTIVE STUDY ON CLINICAL PRESENTATION OF STEROID SENSITIVE NEPHROTIC SYNDROME

Abstract

Sosamma M. M1, Gopi Mohan R2, Jumaly George3

BACKGROUND
Nephrotic syndrome is a disease affecting the renal system. Most paediatricians will invariably encounter children with nephrotic syndrome in their clinic. The disease is characterised by the presence of oedema, persistent heavy proteinuria, hypoproteinaemia and hypercholesterolaemia. The disease is influenced by factors like age, geography, race and also has certain genetic influence related to HLA (DR7, B12, B8). In children, minimal change nephrotic syndrome is the most common variant of primary nephrotic syndrome. It accounts to more than eighty per cent of the cases seen children under seven years whereas it has a chance of fifty per cent in the age group of seven to sixteen years. Males are affected two times higher compared to females. The parents usually bring the child to the hospital with signs of oedema. Usually, the child recovers with treatment, but in some cases, there can be relapse.
MATERIALS AND METHODS
ï?· The study was conducted in the Department of Paediatrics, Travancore Medical College, Kollam.
ï?· The study was done from January 2015 to January 2016.
ï?· Sixty cases were identified and were chosen for the study.
INCLUSION CRITERIA
1. Steroid sensitive cases of nephrotic syndrome.
2. Age less than twelve years.
3. Admitted cases.
EXCLUSION CRITERIA
1. Steroid-resistant and steroid-dependent cases.
2. Age more than twelve years.
3. Outpatient cases.
RESULTS
Out of the sixty cases studied, forty one cases belonged to male sex and nineteen cases belonged to female sex. Based on the age group, maximum number of cases belonged to age group four to eight years, which amounted to thirty four cases followed by age group eight to twelve years, which amounted to eighteen cases. Age group zero to four years had the least number of cases, which amounted to eight in number.
Based on clinical signs and symptoms, fifty five cases presented with oedema either periorbital, scrotal or pedal oedema. Ten cases presented with fever. Nine cases presented with respiratory tract infection. Thirty three cases presented with anorexia, one case presented with diarrhoea, ascites was present in twenty one cases and hypertension was present in eleven cases. Haematuria was seen in fourteen cases and gross proteinuria was seen in all the sixty cases.
CONCLUSION
The study successfully evaluates the gender frequency, age group affected and signs and symptoms that are commonly involved in steroid sensitive nephrotic syndrome.
The present study draws the following conclusions;
ï?· Majority of the cases belonged to male sex.
ï?· Age group four years to eight years were affected in majority of the cases.
ï?· Almost all cases presented with gross proteinuria and oedema.

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