A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma
10.3339/jkspn.2018.22.2.91
- Author:
Soo Hyun KIM
1
;
Hyun Min PARK
;
Joo Hoon LEE
;
Hyery KIM
;
Heounjeong GO
;
Dae Yeon KIM
;
Young Seo PARK
Author Information
1. Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea. pedkid@gmail.kr
- Publication Type:Case Report
- Keywords:
Nephrotic syndrome;
Neuroblastoma;
Infant;
Hyertension
- MeSH:
Aldosterone;
Antihypertensive Agents;
Biopsy;
Blood Pressure;
Catecholamines;
Diagnosis;
Diagnosis, Differential;
Drug Therapy;
Female;
Glomerular Filtration Rate;
Humans;
Hypertension;
Infant;
Nephrotic Syndrome;
Neuroblastoma;
Plasma;
Proteinuria;
Renal Artery;
Renal Veins;
Renin;
Renin-Angiotensin System;
Ultrasonography;
Weight Loss
- From:Childhood Kidney Diseases
2018;22(2):91-96
- CountryRepublic of Korea
- Language:English
-
Abstract:
Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.
