Child Kidney Dis.
2018 Oct;22(2):91-96. 10.3339/jkspn.2018.22.2.91.
A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma
- Affiliations
-
- 1Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea. pedkid@gmail.kr
- 2Department of Pathology, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- 3Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- KMID: 2435378
- DOI: http://doi.org/10.3339/jkspn.2018.22.2.91
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.
Keyword
MeSH Terms
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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
Aldosterone
Antihypertensive Agents
Catecholamines
Renin
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