NEPHRITIC SYNDROME

• 11-year-old boy
• Abdominal pain
• Generalized edema
• Cough (for 10days)
CASE

• Abdominal pain: Acute onset generalized pain
associated with abdominal distention
• Generalized edema: Started the face and
gradually increased decending to the lower
limp .
• Non productive cough associated with
shortness of breathing .

• No past medical history of chronic disease
• No previous hospitalization and blood
transfusion.
• He didn’t took any drug before.

ON EXAMİNATİON
• Patient looks ill, lethargic, full conscious,
orthophnic position.
• Weight: 45 kg (he was 37-40? Before)
• T;37 O;95 BP;140/90 on admission
• Chest; bilateral lower chest were silent
• Abdomen: distended with shifting dullness and
fluid trill .
• Lower limp; pitting edema
• Huge skrotal edema

• Ure: 107 mg/dl
• Kre: 1.49 (GFR: 40-
– modified Schwarz formule)
• Albumin: 3,2 mg/dl
• Electrolyte normal,
• liver enzymes normal
• Crp: 20 mg/L
LABAROTARY AND IMAGING

URINE ANALYSIS
• Microscopic hematuria
• Mild proteinuria
• Mild pyuria

ABDOMINAL USG

• First, to exclude heart failure: EKO were
performed. The result was considered as
changes due to the fluid overload, and EF
were normal.
• We did sputum test; TB result where negative

• Hypertension
• Hematuria
• Mild Proteinuria
• Massive edema
• High renal
markers
Nephritic sydrome?
Nephrotic syndrome?
Mix type?

????????
• We suspect nephritic syndrome.
• We started pulse steriod for 5 days and every
day we are monitring vital signs and input and
ouput .
• After 3days patient improved his creatine and
urea .

• We give patient lasix and at admision his kg
45. and we give him amlodipine for high bp.
• After 9days of admsion ,patient improved and
we discharge with oral prednisalon and
lanzoparazol.
• We planed after 4days tappering predisalone .