Clinical manifestations in children with nephrotic syndrome

Simple nephrotic syndrome clinical manifestations follow certain rules. The disease occurs mainly in children aged 2 to 7 years old often in men than women. Generally slow onset nephrotic syndrome, often without obvious cause, beginning when children still generally good, after gradually pale complexion, listlessness, loss of appetite. Clinical manifestations of nephrotic syndrome has four characteristics:
1. severe edema
Edema is the earliest symptoms began more common in the eyelids and face, morning most obvious. And then gradually throughout the upper and lower extremities and torso, manifestations of systemic edema and gradually increased, with the position change. The most obvious place for facial edema, leg and scrotum. Patients face flat, swollen eyelids can not be opened, thick neck, jaw or even disappear, body skin pale cold, severe scrotal edema when their skin tight thin and transparent, giving the feeling of touch broken, and some even have liquid infiltration out. Patients may have severe and pleural effusion, ascites, Dangxiong water, can cause difficulty breathing, umbilical or inguinal hernia ascites more. Many patients in the thigh and upper arm, abdomen, chest and pregnant women appear similar skin white streaks or purple lines. Edema and acute nephritis, nephrotic "hard edema" is different from the general edema skin soft, the pressure of a depression. Sometimes there was a sudden edema, especially immediately after a respiratory infection, can throughout the body in a few days. With the emergence and increased edema, weight increase of 30% to 50%, reducing the amount of feces, sometimes only 1 or 2 times / B, diarrhea is more common, possibly accompanied with mucosal edema or infection. Above edema may be repeated, persistent for a long time.
2. macroalbuminuria
Proteinuria is the most important manifestation of nephrotic syndrome. Urine protein, mostly citrus ~ ++++, children quantitative> o.1g / kg · d, adult ≥3.58 / d. Most selective proteinuria.
3. Hypoproteinemia
Significantly decreased plasma total protein, albumin (children and adults) as low as 30g children, albumin and globulin ratio is often upside down. Serum protein electrophoresis, albumin, globulin to reduce and p since increased, 7-globulin decreased, 01- globulin normal or reduced.
4. hyperlipidemia
Serum cholesterol in children is higher than 5,70mm01 / L, low-density and very low density lipoprotein can be increased in the early, high-density lipoprotein. Serum albumin <10e / L triglycerides increased. Adult total cholesterol higher than 6.46mm01 / L.
5. Other
Protein loss due to long-term, there may be performance protein malnutrition, hair dry yellow wilt, follicular keratosis, dry skin, prone to rubbing between rash and ulcers, fingers, nails appear white stripes, auricular cartilage soft thin easily squashed. Often malnutrition, anemia. Patients often show fatigue, lack of exercise, indifferent reaction to the surrounding environment. Growth retardation in children, complicated by infection.
Because proteinuria, so combining vitamin D: a protein, transferrin, zinc or copper binding proteins, 1sG, low molecular weight Pak body composition may be excreted in the urine and so lost, resulting in a corresponding clinical symptoms. Some children may appear hepatomegaly in the acute phase. Patients not associated with hematuria. Blood pressure are normal, severe edema can occur a few transient hypertension. In the case of general circulation does not appear sufficient amount of azotemia.

Check the terms of laboratory ESR still evident in the growth rate of more than 100mmol / L or more. Normal serum complement. Fibrin degradation products in urine (FⅢ) more in the L 25Pz / m1 or less.