Nephrotic Syndrome

Puffy

Step 1: View clinicals

A 5-year-old boy presents with a severe headache since waking up today. In the preceding 4 days, he experienced abdominal discomfort and swelling of his face and both legs. His medical and family histories are unremarkable, his growth and development are age appropriate, and all immunizations are up to date. He is on a normal adult diet, and is the only child of non-consanguineous parents. His full blood count, renal functions, and serum electrolytes are all within normal parameters. However, the urinalysis is significant for 3+ proteinuria.


Step 2: Order all relevant investigations

Serum Albumin

Serum Albumin: 1.8 g/dL (3.5-5.0)

MRI + MR venography

There is a diffuse intraluminal thrombus within the superior sagittal sinus, and filling defects caused by thrombi within both transverse sinuses. No infarcts or hemorrhages are noted.

Serum C3 + C4

Serum C3 and C4 levels are within normal parameters.

ANA

The Antinuclear Antibody (ANA) assay is negative


Step 3: Select appropriate management

Corticosteroids
Systemic Thrombolytics
Low Sodium Diet
Furosemide


Score: ★★☆