Abstract

CASE REPORT: STEROID-RESPONSIVE NEPHROTIC SYNDROME IN THIRD RELAPSE COMPLICATED BY PRE-RENAL FAILURE, LOWER RESPIRATORY TRACT INFECTION, THROMBOPHLEBITIS, HYPOPROTEINAEMIA, AND MICROCYTIC HYPOCHROMIC ANAEMIA

Lavanya M., Ragul E.*, Pavithran G., Varnish kumar M. and Sivaramaswamy N.

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Abstract

Background: This case report describes a 4-year, 9-month-old female with steroid-responsive nephrotic syndrome (SRNS) experiencing her third relapse, complicated by pre-renal failure, anasarca, lower respiratory tract infection (LRTI), thrombophlebitis, hypoproteinaemia, and microcytic hypochromic anaemia. The patient presented with facial puffiness, abdominal pain, reduced urine output, and pedal edema. Laboratory findings revealed microcytic hypochromic anaemia, elevated WBC count, fluctuations in renal function tests, hypoproteinaemia, elevated CRP, and significant proteinuria. The patient's urine albumin levels remained elevated during the initial days of treatment, and her weight increased, indicating persistent fluid retention. Methods: The patient was managed with fluid restriction, diuretics, antibiotics, corticosteroids, and albumin infusion. Conclusion: The patient's condition improved with treatment, demonstrating the importance of a multidisciplinary approach in managing relapsing NS. This case report contributes to the understanding of the clinical course and management of complicated relapsing SRNS in children.

Keywords: Steroid-responsive nephrotic syndrome, relapse, pre-renal failure, lower respiratory tract infection, thrombophlebitis, hypoproteinaemia, microcytic hypochromic anaemia.