Families dealing with nephrotic syndrome
Nephrotic syndrome (nephrotic syndrome) is caused by a variety of causes large amount of proteinuria, hypoproteinemia, edema, hyperlipidemia, and other characteristics for a group of clinical syndrome.
Etiology
Cause unknown, and the basic pathological changes in glomerular basement membrane permeability is increased.
Clinical manifestations
Clinical manifestations of systemic edema, hypertension, proteinuria, hypoproteinemia, hyperlipidemia and gastrointestinal symptoms such as loss of appetite, nausea and vomiting, abdominal pain, diarrhea, abdominal distension, and so on.
Diagnosis
(1) whole body swelling, can be associated with serious chest, pericardial effusion and ascites.
(2) hypertension.
(3) proteinuria.
(4) hyperlipidemia: significantly increased serum triglycerides, plasma can be a milky white. Hyperlipidemia also can cause atherosclerosis, thrombosis and embolism occurred.
(5) gastrointestinal symptoms may have loss of appetite, nausea and vomiting, abdominal pain, diarrhea and abdominal distension, and so on.
(6) a large number of urine routine can be all kinds of tubular proteinuria and urine.
(7) lower plasma total protein, globulin white inverted.
(8) blood cholesterol significantly increased.
(9) protein electrophoresis may have α2 and / or β globulin increased significantly, the majority of gamma globulin decreased.
(10) ESR more significantly accelerated, often for 40 to 80 mm / h.
(11) serum antibody, immunoglobulin levels, urinary C3, IgM, γ3 globulin, anti-nuclear antibodies, and other checks can help diagnosis.
(12) renal biopsy can help diagnosis.
Differential diagnosis
With glomerulonephritis, pyelonephritis, and other phase identification, specific see relevant sections.
(1) bed rest, to be dissipated edema, blood pressure returned to normal, can gradually resume normal activities.
(2) strictly limit sodium intake, daily volume perturbation sodium chloride should be two grams following.
(3) provide high-protein, high-calorie diet.
(4) the glucocorticoid response is good, generally do not have to diuretics, hormones invalid, edema can not completely dissipated, can be used urine dihydrochloride grams Thiadiazole 25 ~ 50 mg three times per day, or increase Triamterene Pteridine 50 ~ 100 mg, three times per day.
(5) corticosteroid use prednisone, prednisolone daily 30 ~ 60 mg, in three oral administration.
(6) glucocorticoid application fails, the use of immunosuppressive drugs can be as cyclophosphamide daily 150-200 mg, at 2 to 3 times oral.
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