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.

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

Nephrotic syndrome; Neuroblastoma; Infant; Hyertension

MeSH Terms

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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