| 초록 |
We report the case of a 4-year-old boy with swelling for a week before admission. Swollen starts from around the eyes, three days later followed by swelling in the abdomen and the next day swelled appear in both legs. He had a history of fever and cough, urinating is less than normal, back pain and poor diet. The patient is known to have suffered from nephrotic syndrome since 2 years ago and had been admission once a year. Examination revealed bilateral pedal edema and ascites. Laboratory investigation shows low hemoglobin (11,5 g/dl), elevated leukocyte (15.460/mm3), hypoalbuminemia (1,3 g/dL), hypercholesterolemia (627 mg/dL) and low total protein (3,4 g/dL). He had erythrocyte 12 cell/HPF and protein +3 in the urine. We could not perform biopsy due to a lack of facilities. We made a diagnosis of infrequent relapses nephrotic syndrome. The patients were admitted and treated with a nephrotic diet, oral prednisone, oral furosemide and oral spironolactone, and calcium supplementation. The edema resolved and his general condition improved. He was discharged to follow up. Diagnosis can be made from clinical findings and laboratories. However, a kidney biopsy is important for diagnosis to determine the type of nephrotic syndrome and improve further treatment outcomes for the patients. |