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Nephrotic Syndrome

Edema and Nephrotic syndrome

Lymphedema and Nephrotic Syndrome

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Nephrotic Syndrome

Related terms:

Nehprosis, Edema, Kidney Failure, Hypertension, Vein thrombosis, Arteriosclerosis, Albumin, Anasarco, NS, Amyloidosis, Congenital nephrosis, Glomerular sclerosis, FSGS, Glomerulonephritis, GN,  IgA nephropathy, Berger's Disease, Minimal change disease, MDC, Pre-eclampsia, Osteoporosis, Multiple myeloma, Systemic lupus erythematosus, Mesangiocapillary glomerulonephritis, Diabetes, Hyperproteinemia, Hyperlipedemia, Anarsca, Hyperalbunemia, Membranous Nephropathy, Primary Nephrotic Syndrome, Lipoid Nephorsis, NIL, lymphedema, Pitting edema 

Discussion:

Nephrotic syndrome is a kidney disorder in which damage has occurred to the kidneys in the kidney's filtering system called the glomeruli. The resulting central feature is loss of proteins, albumin and globulin in the urine with the subsequent low levels of protein in both the blood.  This condition is called proteinuria.  Nephrotic Syndrome is a rare condition affecting approximately two in every ten thousand individuals.   In children, it is general diagnosed between two and three years old and has a high rate among males than females.

Causes:

The condition can be caused by a multitude factors.  These include infection, drug exposure, hereditary disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis (the stiffening and subsequent malfunction of the kidney due to fibrous protein deposit in the tissue) .  It can also accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis and mesangiocapillary glomerulonephritis.

The following diseases can cause specific damage to the glomeruli and often result in the development of heavy proteinuria and in many instances NS: (1)

In children the most common cause is minimal change disease. A disease of unknown etiology, it cause loss of protein through the urine. It is also difficult to diagnosis because biopsy result show up normal of near normal.

Clinical features:

Patients will present with four main considerations.

1. High levels of protein in the urine

2. Low levels of protein in the blood (hypoalbuminemia)

3. High levels of cholesterol in the blood (hypercholesterolemia)

4. Edema, often severe usually involving the lower legs and feet. This may be referred to as focal edema.

Other clinical symptoms may include frothy urine, anoxrexia, malaise, retinal sheen, abdominal pain and wasting of muscles.

Complications:

Complications can also include renal (kidney) failure, hypertension, susceptibility to infections and blood clotting (thrombosis).  Other complications include hypoproteinemia, hypoalbunemia, hyperlipedemia with elevated cholesterols, triglicerides, other lipids and edema.

Nephrotic related edema causes tissues to be soft, puffy and impressionable (pitting edema) to the touch.   Initially the edema will be in the legs, but in later stages will progress to  abdomen, hands and even around the eyes.  In very late stages the entire body may experience swelling (anasarca).In situations of edema, especially with marked edema, the skin may ooze clear fluids and breakdown of tissue is common.  While the weeping wound complication of nephrotic syndrome is similar to the weeping wounds of lymphedema, the two condition are distinctly different.

Diagnosis:

In addition to blood tests, and urinalysis, the most important diagnostic tool is a kidney biopsy.  The kidney biopsy may reveal the underlying cause and extent or progression of the disease.

Treatment:

The course of treatment for Nephrotic Syndrome includes the various complications.  This is referred to as "nonspecific treatment."  These treatment include Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications and antibiotics for infections. Supportive treatment may also include diet, high in quality protein and fiber, but low in saturated fat and cholesterol.

Specific treatment focuses on the underlying causes of the condition. 

Treatment for the edema may include diuretics and or decongestive massage therapy. I

Treatment of minimal change disease in children usually involves the use of diuretics for the relief of edema and the use of a corticosteroid called prednisone. Minimal Change Disease may also be referred to as Lipoid Nephorsis or NIL Disease.

Other features of treatment may include hospitilization, a prolonged period of treatment,  frequent monitoring by patients and doctors, administration of drug associated with significant adverse events. (2)

Prognosis:

Patient prognosis depends on several factors.  The most important one being the cause or underlying reason for the condition.  Also, some patients may have a spontaneous remission while others experience a gradual progression of the condition.  

Other factors will include reactions or complications from the treatment modalities.  Some of these complications include atherosclerosis (hardening of the arteries),  and adverse reaction to steroids.  These reactions include osteoporosis, cataracts, increased  risk of infections and even diabetes.

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Childhood Nephrotic Syndrome

This fact sheet has been written to tell you some facts about a kidney disease called the nephrotic syndrome. This illness also is called nephrosis or minimal change disease. The brochure will give you and your family information about your child's illness. It will tell you what will happen with this illness. You also should talk to your doctor. The more you know, the more you can help your child.

What do the kidneys do?

The kidneys are two fist-sized organs found in the lower back. When they are working well, they clean the blood, and get rid of waste products, excess salt and water. When diseased, the kidneys may get rid of things that the body needs to keep, such as blood cells and protein.

What is the nephrotic syndrome?

This is an illness where the kidney loses protein in the urine. This causes protein in the blood to drop, and water moves into body tissues, causing swelling (edema). You will see the swelling around the child's eyes, in the belly, or in the legs. Your child will not go to the bathroom as often as usual and will gain weight with the swelling.

Do other kidney diseases cause edema and protein in the urine?

Yes. Edema and protein in the urine are common in other types of kidney disease, especially a disease called glomerulonephritis.

What causes the nephrotic syndrome?

In the majority or cases, the cause is not known. The National Kidney Foundation has active research programs into causes and treatments of the nephrotic syndrome.

Who gets it?

Usually, young children between the ages of 1 1/2 and 5. It happens twice as often in boys as girls. However, children of all ages and adults also can get it.

How can you tell if your child has it?

You may see that your child has swelling around the eyes in the morning. You may think that your child has an allergy. Later, the swelling may last all day, and you may see swelling in your child's ankles, feet and belly. Also, your child may be:

• more tired & more irritable
• eating less
• pale looking

The child may have trouble putting on shoes or buttoning clothes because of swelling.

How is the nephrotic syndrome treated?

The treatment will try to stop the loss of protein in the urine, and increase the amount of urine. Usually, the doctor will start your child on a drug called prednisone. Most children get better with this drug.

What does prednisone do?

Prednisone is used to stop the loss of protein from the blood into the urine. After one to four weeks of treatment, your child should begin going to the bathroom more often. As your child makes more urine, the swelling will go away.

When there is no protein in the urine, the doctor will begin to reduce the amount of prednisone over several weeks. The doctor will tell you exactly how much prednisone to give your child each day. Never stop prednisone, unless the doctor tells you to do so. If you stop this drug or give your child too much or too little, he or she may get very ill.

Sometimes, your child will stay healthy after treatment. Your child may relapse (get sick again) at any time, even after a long time with good health. Getting sick may happen after a viral infection, such as a cold or the flu.

What problems call occur with prednisone?

Prednisone can be a very good drug, but it has a number of side effects. Some of these side effects are:

• being hungry
• gaining weight 
• acne (pimples)
• mood changes (very happy, then very sad)
• being overactive
* more chance of infection
• slowing of growth rate

Side effects are more common with larger doses and if it is used for a long time; once prednisone is stopped, most of these side effects go away.

What if prednisone does not work?

If prednisone does not work for your child or if your child has serious side effects, the doctor may order another kind of medicine, called an immunosuppressive drug. These drugs decrease the activity of the body's immune system. They are effective in most, but not all, children. Your doctor will discuss in detail with you the good and bad things about the drug. The side effects of these drugs include: increased susceptibility to infections, hair loss and increased blood cell production.

Parents also should be aware that children taking immunosuppressive drugs may become ill if they develop chicken pox. Therefore, you should notify your doctor any time that your child is exposed to chicken pox while on these medications.

Your child also may be given diuretics (water pills). These drugs help the kidney get rid of salt arid water. The most common water pill used in children is called furosemide. If your child starts to have a problem with vomiting or diarrhea, you should call your doctor as the child can lose too much fluid and become even sicker. Once protein disappears from the urine, diuretics should  stopped.

What other problems happen with the nephrotic syndrome?

Most children will have problems only with swelling. However, a child with nephrotic syndrome can develop a serious infection in the belly. If your child has a fever or starts complaining of severe pain in the belly, you should call your doctor at once.

Sometimes, children with nephrotic syndrome get blood clots in their legs. If this happens, your child will complain of:'

• severe pain in arm or leg
• swelling of arm or leg
• changes in color or  temperature of arm or leg

If any of these things happens, you should call your doctor right away.

What can parents do?

Much of your child's care will be given by you. Pay attention to your child's health, but do not overprotect the child. If your child is ill or taking prednisone, the doctor will recommend a low salt diet. This type of diet will make your child more comfortable by keeping the swelling down. Try to give your child foods that he or she likes, but that are low in salt. Ask the dietitian for suggestions.

Usually, the child will be allowed to drink as much as he or she wants. A child's natural thirst is the best guide as to how much to drink. You should also weigh your child and keep a record of weight to spot a change in the disease.

The first sign that your child is getting sick again is the return of protein in the urine. Because of this, many doctors ask you to check your child's urine regularly. To do this, a special plastic strip with a small piece of paper on the end is dipped into the urine. The paper will change color when protein is in the urine. This test can be done easily at home and it can detect a relapse before any swelling is seen. Check with your doctor to learn how to do the test and how often to do it.

When there is swelling, check that your child's clothing is not too tight because the clothing can rub the child's skin over the swollen areas. This can make the skin raw, and it may get infected.

Your child will probably have this disease several years. It is very important to treat your child as normally as possible. Your child needs to continue his or her usual activities, such as going to school and seeing friends. Your child should be treated just like other children in the family in terms of discipline. Occasionally, your child may not go to school for a time. Your doctor will let you know if this is necessary. Keeping your child out of school or not letting him or her see friends will not change the illness.

Does the disease ever go away?

Sometimes. Even though the nephrotic syndrome does not have a specific cure, the majority of children "outgrow" this disease in their late teens or early adulthood. Some children will have only one attack of the nephrotic syndrome. If your child does not have another attack for three years after the first one, the chances are quite good that he or she will not get sick again.

Still, most children will have two or more attacks, The attacks are more frequent in the first one to two years after the nephrotic syndrome begins. After ten years, less than one child in five is still having attacks. Even if a child has a number of attacks, most will not develop permanent kidney damage. The major problem is to control their accumulation of fluid using prednisone and diuretics. Children with this disease have an excellent long-term outlook.

What else should I know?

1. Most children with the nephrotic syndrome respond to treatment.

2. Most children with the nephrotic syndrome have an excellent long-term outcome.

3. You should feel free to ask your child's doctor any questions.

What if I have more questions?

If you have more questions, you should speak to your doctor. You also can get additional information by contacting your local National Kidney Foundation Affiliate.

What is The National Kidney Foundation and how does it help?

Twenty million Americans have some form of kidney or urologic disease. Millions more are at risk. The National Kidney Foundation, Inc., a major voluntary health organization, is working to find the answers through prevention, treatment and cure. Through its 50 Affiliates nationwide, the Foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of The National Kidney Foundation is funded entirely by public donations.

http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/nephrotic_syndrom/

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Nephrotic Syndrome

Alternative names

Nephrosis

Definition

Nephrotic syndrome is a constellation of signs and symptoms including protein in the urine (exceeding 3.5 grams per day), low blood protein levels, high cholesterol levels, and swelling. The urine may also contain fat, which is visible under the microscope.

Causes, incidence, and risk factors  

Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.

The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.

This condition can also occur as a result of infection, drug exposure, malignancy, hereditary disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis. It can accompany kidney disorders, including glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.

Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. Males are slightly more likely to be affected than females.

Symptoms  

Signs and tests

Physical examination can detect some symptoms. Other symptoms and signs of causative disorders can also be found with examination.

Urinalysis reveals large amounts of urine protein. Fats are often also present in the urine.

Tests to rule out various causes may include the following:
This disease may also alter the results of the following tests:

Treatment  

The goals of treatment are to relieve symptoms, prevent complications and delay progressive kidney damage. Treatment of the causative disorder is necessary to control nephrotic syndrome. Treatment may be required for life.

Corticosteroid, immunosuppressive, antihypertensive, and diuretic medications may help control symptoms. Antibiotics may be needed to control infections. Angiotensin converting enzyme (ACE) inhibitors may significantly reduce the degree of protein loss in the urine and are therefore frequently prescribed for treatment of nephrotic syndrome.

If hypertension occurs, it must be treated vigorously. Treatment of high blood cholesterol and triglyceride levels is also recommended to reduce the risk of atherosclerosis. Dietary limitation of cholesterol and saturated fats may be of little benefit, as the high levels which accompany this condition seem to be the result of overproduction by the liver rather than from excessive fat intake. Medications to reduce cholesterol and triglycerides may be recommended.

High-protein diets are of debatable value. In many patients, reducing the amount of protein in the diet produces a decrease in urine protein. In most cases, a moderate-protein diet (1 gram of protein per kilogram of body weight per day) is usually recommended. Sodium (salt) may be restricted to help control swelling. Vitamin D may need to be replaced if nephrotic syndrome is chronic and unresponsive to therapy.

Blood thinners may be required to treat or prevent clot formation.

Expectations (prognosis)  

The outcome varies; the syndrome may be acute and short-term or chronic and unresponsive to therapy. The cause and development of complications also affects the outcome.

Complications 

Calling your health care provider

Call your health care provider if symptoms which may indicate nephrotic syndrome occur.

Call your health care provider if nephrotic syndrome persists or if new symptoms develop, including severe headache, fever, sores on the skin, cough, discomfort with urination, or decreased urine output.

Go to the emergency room or call the local emergency number (such as 911) if convulsions occur.

Prevention  

Treatment of causative disorders may prevent development of nephrotic syndrome.

Medline Plus medical Encyclopedia

Updated by: Irfan A. Agha, M.D., Department of Medicine, Renal Division, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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Abstracts and Studies

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Primary lymphedema in the nephrotic syndrome: case report

Wagner U, Balzar E, Khoss A, Partsch H.

Universitäts-Kinderklinik, Wien.

The aim of this case report is to discuss possible connections between the development of a hypoproteinaemic oedema due to the nephrotic syndrome and the occurrence of lymphedema. Two patients (a three year-old girl and a seven year-old boy) developed lymphedema of one leg one year after the onset of the nephrotic syndrome. The case of the six year-old girl is presented. Malignancy was excluded by clinical investigation. Direct lymphography failed to show any peripheral lymph-vessels; indirect lymphography (i.c. infusion of a newly-developed contrast medium) revealed hypoplasia of the peripheral lymph-collectors. The development of lymphoedema 12-18 months after the appearance of the nephrotic syndrome supports the hypothesis that the increase in extravascular fluid, which is caused by a reduced oncotic pressure in the plasma, may trigger off the development of lymphoedema if there is a primary defect of the lymphatic system.

PMID: 3687024 [PubMed - indexed for MEDLINE]

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End-stage renal disease in a patient with congenital lymphangiectasia and lymphedema

Kostas I. Sombolos1, Aristea I. Papachillea1, Taisir M. Natse1, Kostas I. Gogos1, Georgios O. Pavlidis1, Kostas A. Barboutis1 and Kostas S. Mavromatidis1

(1)  Renal Unit G.H. ”G. Papanikolaou,” Thessaloniki, Greece, GR
(2)  Vas. Olgas 82, 546 43, Thessaloniki, Greece e-mail: sobolos@spark.net.gr Fax: +30-31-829963, GR
Abstract:  Congenital lymphangiectasia with lymphedema is a disorder constituting the main defect in many different genetic syndromes. Herein we describe a 23-year-old male patient with congenital lymphangiectasia and severe lymphedema of the right leg, scrotum, and abdominal wall, who presented with end-stage renal disease, presumably due to cystic renal lymphangiectasia, and is undergoing chronic hemodialysis treatment.

Keywords: End-stage renal disease - Hemodialysis - Lymphangiectasia - Lymphedema

SpringerLink

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Yellow Nails and Minimal Change Nephrotic Syndrome

Sonsoles Yáñeza, J. Fernando Val-Bernalb, Héctor Fernández-Llacaa

aDermatology Service and
bAnatomical Pathology Department, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain

Key Words:

Abstract

We report a case of a 38-year-old man showing the yellow nail syndrome in association with minimal change nephrotic syndrome. Treatment with prednisone and vitamin E resulted in complete resolution of the nephrotic syndrome and slow improvement of the yellow nails, respectively. Although the rare yellow nail syndrome has been described in association with renal disease, this is the first report of the association of this syndrome with minimal change nephrotic syndrome.

Author Contacts

Dr. J. Fernando Val-Bernal
Departamento de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla
Avda. Valdecilla 1
E-39008 Santander (Spain)
Tel. +34 942 202 599, Fax +34 942 201 903

Karger

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Rituximab treatment for severe steroid- or cyclosporine-dependent nephrotic syndrome: a multicentric series of 22 cases.

Pediatr Nephrol. 2008 May

Guigonis V, Dallocchio A, Baudouin V, Dehennault M, Hachon-Le Camus C, Afanetti M, Groothoff J, Llanas B, Niaudet P, Nivet H, Raynaud N, Taque S, Ronco P, Bouissou F.

Department of Pediatrics, Centre de référence des maladies rénales rares du Sud-Ouest, Hôpital de la mère et de l’enfant, 8 Ave Dominique Larrey, 87000, Limoges, France, vincent.guigonis@chu-limoges.fr

Several case reports suggest that rituximab (RTX) could be effective in steroid-dependent nephrotic syndrome, but RTX efficacy has not yet been studied in a series of patients. Safety and efficacy of RTX were assessed in a multicenter series of 22 patients aged 6.3-22 years with severe steroid-dependent nephrotic syndrome or steroid-resistant but cyclosporin-sensitive idiopathic nephrotic syndrome. Patients were treated with two to four infusions of RTX. Seven patients were nephrotic at the time of RTX treatment. Peripheral B cells were depleted in all subjects. Remission was induced in three of the seven proteinuric patients. One or more immunosuppressive (IS) treatments could be withdrawn in 19 patients (85%), with no relapse of proteinuria and without increasing other IS drugs. RTX was effective in all patients when administered during a proteinuria-free period in association with other IS agents. When relapses occurred, they were always associated with an increase in CD19 cell count. Adverse effects were observed in 45% of cases, but most of them were mild and transient. This study suggests that RTX could be an effective treatment for severe steroid-dependent nephrotic syndrome.

PMID: 18465150 [PubMed - as supplied by publisher]

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Molecular Pathology of Nephrotic Syndrome in Childhood. A Contemporary Approach to Diagnosis.

Pediatr Dev Pathol. 2008 May

Liapis H.

Molecular and genetic studies in the last two decades have shed new light in the understanding of congenital and infantile nephrotic syndrome (NS). Glomerular pathology may appear as minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS) or diffuse mesangial sclerosis, glomerular diseases now recognized as podocyte injuries, in part caused by altered podocyte genes. Even though genetic mutations are not implicated in all infants with NS, the study of familial disease and congenital NS reveals that proteinuria is in part due to specific gene mutations. The most common mutations are in four genes, three of which are podocyte genes: NPHS1 (Finnish nephropathy), NPHS2 (PODOCIN induced FSGS), WT1 (Diffuse Mesangial Sclerosis) and LAMB2 (Pierson syndrome). Furthermore, these studies have improved our understanding of steroid resistant NS in older children, particularly girls, in whom proteinuria may be to WT1 mutations. Availability of molecular genetic testing and antibodies to specific gene products are closing the gap between histopathology of pediatric glomerular disease and molecular genetic diagnosis. Recognition of NS variants which may be reversible, for example mitochondrial mutations and viral disease is important. This review discusses the most common entities and the differential diagnosis of pediatric NS from the pathologist point of view, with emphasis on congenital (<3months) and infantile (3months-1 year) NS in the light of molecular and genetic studies.

PMID: 18462046 [PubMed - as supplied by publisher]

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Autoimmune thyroiditis in a child with steroid-dependent nephrotic syndrome.

Eur J Pediatr. 2008 May

Tasic V, Angjeleska M, Ristoska-Bojkovska N, Petrusevska G, Gucev Z.

Department of Pediatric Nephrology, University Children’s Hospital, 17 Vodnjanska, 1000, Skopje, Macedonia, vtasic@freemail.com.mk

Autoimmune thyroiditis is rarely described in association with nephrotic syndrome. Herein we report a girl who developed autoimmune thyroiditis insidiously during the course of minimal change nephrotic syndrome. She was streroid-sensitive, but developed severe steroid dependency and did not respond to cyclophosphamide therapy. She went into stable remission with levamisole. Five months after introduction of levamisole a mild goiter was found on systematic examination at school. The diagnosis of autoimmune thyroiditis was established with typical ultrasound appearance of the thyroid gland along with significant titers of antithyroid antibodies. It is very unlikely that levamisole was responsible for thyroiditis because experimental animal administration of high doses of levamisole inhibited lymphocyte infiltration of the thyroid. Since levamisole has had a beneficial effect on the nephrotic syndrome in our patient we decided to continue the treatment. She has been receiving levamisole for 3

Springer Link

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Portal vein thrombosis as the first sign of nephrotic syndrome.

Nat Clin Pract Nephrol. 2008 May

Sun L, Xu C; Vanderbilt.

L Sun is an Attending Doctor and C Xu is a Professor in the Division of Nephrology at Changzheng Hospital, Second Military Medical University, Shanghai, China.

Background A 52-year-old man presented to hospital having experienced abdominal pain, abdominal distention and oliguria for 1 week. An abdominal CT scan revealed thrombosis in the superior mesenteric vein and in the right branch and the trunk of the portal vein.Investigations Physical examination, blood and urine analyses, color Doppler ultrasonography and abdominal CT scan.Diagnosis Nephrotic syndrome complicated by portal vein thrombosis.Management Treatment with batroxobin, low-molecular-weight heparin, prostaglandin E, dipyridamole and methylprednisolone.

Nature

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Primary Lymphoedema at an Unusual Location Triggered by Nephrotic Syndrome 

Jul 2010

Tabel Y, Mungan I, Sigirci A, Gungor S.

Source

Department of Paediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey. yilmaztabel@yahoo.com

Abstract

INTRODUCTION:

Lymphoedema results from impaired lymphatic transport leading to the pathologic accumulation of protein-rich lymphatic fluid in the interstitial space, most commonly in the extremities. Primary lymphoedema, a developmental abnormality of the lymphatic system, may become evident later in life when a triggering event exceeds the capacity of normal lymphatic flow.

CLINICAL PICTURE:

We present a 3-year-old nephrotic syndrome patient with an unusual localisation for primarylymphoedema.

TREATMENT AND OUTCOME:

The patient was treated with conservative approach and she was cured.

CONCLUSION:

In this particular case, lymphoedema developed at an unusual localisation, which has not been recorded before.

http://www.annals.edu.sg/pdf/38VolNo7Jul2009/V38N7p636.pdf

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External Links:

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Nephrotic Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001520/

Treatment of steroid-resistant pediatric nephrotic syndrome.

http://www.ncbi.nlm.nih.gov/pubmed/22087197

Childhood Nephrotic Syndrome

http://kidney.niddk.nih.gov/kudiseases/pubs/childhoodnephrotic/index.htm

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Nephrotic Syndrome in Adults

http://kidney.niddk.nih.gov/kudiseases/pubs/nephrotic/index.htm

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Nephrotic Syndrome (2)

eMed

http://www.emedicine.com/ped/topic1564.htm

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Nephrotic Syndrome

Pediatrics on Call

http://www.pediatriconcall.com/forpatients/CommonChild/nephroticsyndrome.asp

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Nephrotic Syndrome (NS) (1)

http://www.nephrologychannel.com/nephrotic/

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Nephrotic syndrome

http://www.drkoop.com/ency/article/000490.htm

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Nephrotic Syndrome

GP Notebook

http://www.gpnotebook.co.uk/simplepage.cfm?ID=-1167392767

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A case of steroid-resistant nephrotic syndrome associated with systemic lupus erythematosus. Dec 2011

http://lup.sagepub.com/content/early/2011/12/19/0961203311432740.long

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Congenital syphillis presenting congenital nephrotic syndrome in two children and related data review Dec 2011

http://www.ncbi.nlm.nih.gov/pubmed/22178846

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Evaluation of Pulmonary Embolism in Pediatric Patients with Nephrotic Syndromewith Dual Energy CT Pulmonary Angiography.  Dec. 2011

http://www.sciencedirect.com/science/article/pii/S1076633211005514

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Nephrotic Syndrome

Renal Unit of the Royal Infirmary of Edinburgh

http://renux.dmed.ed.ac.uk/EdREN/EdRenINFObits/NephroticLong.html

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Membranous Nephropathy

http://www.nlm.nih.gov/medlineplus/ency/article/000472.htm

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Minimal Change Nephropathy

http://www.emedicine.com/med/topic1483.htm

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Lithium-induced nephrotic syndrome in a prepubertal boy.

2008 Apr

Mary Ann Liebert

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Neprhrotic syndrome in a patient with rheumatoid arthritis treated with adalimumab: a case report

Reumatismo. 2008 Jan-Mar

http://www.reumatismo.org/index.php/reuma/article/view/Reumatismo.2008.61

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Recent progress in the pathogenesis of nephrotic proteinuria.

2008

IInformaWorld

http://informahealthcare.com/doi/abs/10.1080/10408360801934865%20

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Anasarca: not a nephrotic syndrome but dermatomyositis.

2008 Apr

SpringerLink

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ICD-10 /  ICD-9 and External Resources

ICD-10

N04 

Nephrotic syndrome
[See before N00 for subdivisions ]
Includes: congenital nephrotic syndrome
lipoid nephrosis

N05

Unspecified nephritic syndrome
[See before N00 for subdivisions ]
Includes: glomerular disease
glomerulonephritis
nephritis
}
}
}
NOS
nephropathy NOS and renal disease NOS with morphological lesion specified in .0-.8 before N00.-
Excludes: nephropathy NOS with no stated morphological lesion ( N28.9 )
renal disease NOS with no stated morphological lesion ( N28.9 )
tubulo-interstitial nephritis NOS ( N12 )

ICD-9

2008 ICD-9-CM Diagnosis 581.9

Nephrotic syndrome with unspecified pathological lesion in kidney

  • Descriptive histopathologic term for renal disease without an inflammatory component.
  • 581.9 is a specific code that can be used to specify a diagnosis
  • 581.9 contains 22 index entries
  • View the ICD-9-CM Volume 1 581.* hierarchy

581.9 also known as:

  • Glomerulonephritis with edema NOS
  • Nephritis:
    • nephrotic NOS
    • with edema NOS
  • Nephrosis NOS
  • Renal disease with edema NOS
Disease DB 8905
eMedicine med/1612  ped/1564
MESH D009404

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See also:

Edema 

http://www.lymphedemapeople.com/wiki/doku.php?id=edema

Edema and Chronic Venous Insufficiency

http://www.lymphedemapeople.com/thesite/edema_chronic_venous_insufficiency.htm

Edema and Deep Venous Thrombosis

http://www.lymphedemapeople.com/thesite/lymphedema_deep_venous_thrombosis.htm

Edema and Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome

http://www.lymphedemapeople.com/thesite/edema_and_reflex_sympathetic_dystrophy.htm

Edema and Venous Pooling

http://www.lymphedemapeople.com/thesite/edema_and_venous_pooling.htm

Angioedema

http://www.lymphedemapeople.com/wiki/doku.php?id=angioedema

Edema of the Neck

http://www.lymphedemapeople.com/thesite/lymphedema_of_the_neck.htm

Edema and Nephrotic Syndrome

http://www.lymphedemapeople.com/thesite/edema_nephrotic_syndrome.htm

Edema of the Face

http://www.lymphedemapeople.com/thesite/edema_of_the_face.htm

Thrombophlebitis

http://www.lymphedemapeople.com/wiki/doku.php?id=thrombophlebitis

Edema and Diabetes

http://www.lymphedemapeople.com/thesite/lymphedema_and_diabetes.htm

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Join us as we work for lymphedema patients everywehere:

Advocates for Lymphedema

Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.

http://health.groups.yahoo.com/group/AdvocatesforLymphedema/

Subscribe: AdvocatesforLymphedema-subscribe@yahoogroups.com

Pat O'Connor

Lymphedema People / Advocates for Lymphedema

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For information about Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema\

For Information about Lymphedema Complications

http://www.lymphedemapeople.com/wiki/doku.php?id=complications_of_lymphedema

For Lymphedema Personal Stories

http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=3

For information about How to Treat a Lymphedema Wound

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound

For information about Lymphedema Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment

For information about Exercises for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema

For information on Infections Associated with Lymphedema

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema

For information on Lymphedema in Children

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children

Lymphedema Glossary

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing

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Lymphedema People - Support Groups

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Children with Lymphedema

The time has come for families, parents, caregivers to have a support group of their own. Support group for parents, families and caregivers of chilren with lymphedema. Sharing information on coping, diagnosis, treatment and prognosis. Sponsored by Lymphedema People.

http://health.groups.yahoo.com/group/childrenwithlymphedema/

Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com

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Lipedema Lipodema Lipoedema

No matter how you spell it, this is another very little understood and totally frustrating conditions out there. This will be a support group for those suffering with lipedema/lipodema. A place for information, sharing experiences, exploring treatment options and coping.

Come join, be a part of the family!

http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515

Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com

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MEN WITH LYMPHEDEMA

If you are a man with lymphedema; a man with a loved one with lymphedema who you are trying to help and understand come join us and discover what it is to be the master instead of the sufferer of lymphedema.

http://health.groups.yahoo.com/group/menwithlymphedema/

Subscribe: menwithlymphedema-subscribe@yahoogroups.com

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All About Lymphangiectasia

Support group for parents, patients, children who suffer from all forms of lymphangiectasia. This condition is caused by dilation of the lymphatics. It can affect the intestinal tract, lungs and other critical body areas.

http://health.groups.yahoo.com/group/allaboutlymphangiectasia/

Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com

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Lymphatic Disorders Support Group @ Yahoo Groups

While we have a number of support groups for lymphedema... there is nothing out there for other lymphatic disorders. Because we have one of the most comprehensive information sites on all lymphatic disorders, I thought perhaps, it is time that one be offered.

DISCRIPTION

Information and support for rare and unusual disorders affecting the lymph system. Includes lymphangiomas, lymphatic malformations, telangiectasia, hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of information available through sister site Lymphedema People.

http://health.groups.yahoo.com/group/lymphaticdisorders/

Subscribe: lymphaticdisorders-subscribe@yahoogroups.com

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All About Lymphedema

For our Google fans, we have just created this online support group in Google Groups:

Homepage: http://groups-beta.google.com/group/All-About-Lymphedema

Group email: All-About-Lymphedema@googlegroups.com

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Lymphedema Friends

http://groups.aol.com/lymphedemafriend

If you an AOL fan and looking for a support group in AOL Groups, come and join us there.

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Lymphedema People New Wiki Pages

Have you seen our new “Wiki” pages yet?  Listed below are just a sample of the more than 140 pages now listed in our Wiki section. We are also working on hundred more.  Come and take a stroll! 

Lymphedema Glossary 

http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing 

Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema 

Arm Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=arm_lymphedema 

Leg Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=leg_lymphedema 

Acute Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=acute_lymphedema 

The Lymphedema Diet 

http://www.lymphedemapeople.com/wiki/doku.php?id=the_lymphedema_diet 

Exercises for Lymphedema  

http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema 

Diuretics are not for Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=diuretics_are_not_for_lymphedema 

Lymphedema People Online Support Groups 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_online_support_groups 

Lipedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema 

Treatment 

http://www.lymphedemapeople.com/wiki/doku.php?id=treatment 

Lymphedema and Pain Management 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pain_management 

Manual Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT)

http://www.lymphedemapeople.com/wiki/doku.php?id=manual_lymphatic_drainage_mld_complex_decongestive_therapy_cdt 

Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema 

How to Treat a Lymphedema Wound 

http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound 

Fungal Infections Associated with Lymphedema 

http://www.lymphedemapeople.com/wiki/doku.php?id=fungal_infections_associated_with_lymphedema 

Lymphedema in Children 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children 

Lymphoscintigraphy 

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphoscintigraphy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Extraperitoneal para-aortic lymph node dissection (EPLND) 

http://www.lymphedemapeople.com/wiki/doku.php?id=extraperitoneal_para-aortic_lymph_node_dissection_eplnd 

Axillary node biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=axillary_node_biopsy

Sentinel Node Biopsy 

http://www.lymphedemapeople.com/wiki/doku.php?id=sentinel_node_biopsy

 Small Needle Biopsy - Fine Needle Aspiration 

http://www.lymphedemapeople.com/wiki/doku.php?id=small_needle_biopsy 

Magnetic Resonance Imaging 

http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging 

Lymphedema Gene FOXC2

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_foxc2

 Lymphedema Gene VEGFC

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_vegfc

 Lymphedema Gene SOX18

 http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_sox18

 Lymphedema and Pregnancy

http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy

Home page: Lymphedema People

http://www.lymphedemapeople.com

Page Updated: Nov 16,  2011