【医学课件】病例-肾病综合征(英文版)
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• And then lower extremities edema • oliguria • foamy urine
Past Medical History
• The second child in his family • Full-term product of an uncomplicated
• TORCH negtive • ANA negtive • PPD test negtive • Completment 3 level and serum
creatinnine normal • X ray : normal • Ultrasonography :normal
Most likely diagnosis
eyes • shifting dullness(negative) • Heart and lung auscultation is normal • no rash • He is afebrile
Urinalysis
• Dipstick blood negative protein 4+ specific gravity 1.035
• Microscope RBC negative WBC negative
Complete blood count
• WBC 8.95*10^9/L, N 47.2% • Hb 129g/L • Plt 371*10^9/L • CRP<1mg/L
• Primary diagnosis ? • Further examinations?
Further examinations
• ESR 77mm/h • Serum albumin 13.8g/L • Serum cholesterol 3.03 mmol/L • Serum triglyceride 9.77 mmol/L
• Protein/creatinine ratio 3.72 • Total urine protein 2081mg/24hr
• No family members with kidney disease, rheumatoid disease, or neoplasia
Social History
• Lives with parents in city • No pets or recent travel
PX
• weight 12kg BP 90/56 mmHg 源自文库 edema in lower extremitis and around the
•nephrotic syndrome (NS)
Treatment
• Low-sodium diet • Diuresis: Spironolactone and
hydrochlorothiazide • Iv albumin 10g • Steroid: methylprednisolone 16mg/d iv for
pregnancy • Growth and development normal • No history of hospitalization and surgery • Allergies: None known • Immunizations: Up to date
Family History
case
Personal information : 1year 8 months old male
Chief complaint : edema around the eyes and in the lower extremities for 7 days
• seven days prior he parents noticed his periorbital edema
10days--then prednisone 10mg bid po
Case report
• 4 days later :edema remission • 11days later: urine protein （-）
Thank you
Past Medical History
• The second child in his family • Full-term product of an uncomplicated
• TORCH negtive • ANA negtive • PPD test negtive • Completment 3 level and serum
creatinnine normal • X ray : normal • Ultrasonography :normal
Most likely diagnosis
eyes • shifting dullness(negative) • Heart and lung auscultation is normal • no rash • He is afebrile
Urinalysis
• Dipstick blood negative protein 4+ specific gravity 1.035
• Microscope RBC negative WBC negative
Complete blood count
• WBC 8.95*10^9/L, N 47.2% • Hb 129g/L • Plt 371*10^9/L • CRP<1mg/L
• Primary diagnosis ? • Further examinations?
Further examinations
• ESR 77mm/h • Serum albumin 13.8g/L • Serum cholesterol 3.03 mmol/L • Serum triglyceride 9.77 mmol/L
• Protein/creatinine ratio 3.72 • Total urine protein 2081mg/24hr
• No family members with kidney disease, rheumatoid disease, or neoplasia
Social History
• Lives with parents in city • No pets or recent travel
PX
• weight 12kg BP 90/56 mmHg 源自文库 edema in lower extremitis and around the
•nephrotic syndrome (NS)
Treatment
• Low-sodium diet • Diuresis: Spironolactone and
hydrochlorothiazide • Iv albumin 10g • Steroid: methylprednisolone 16mg/d iv for
pregnancy • Growth and development normal • No history of hospitalization and surgery • Allergies: None known • Immunizations: Up to date
Family History
case
Personal information : 1year 8 months old male
Chief complaint : edema around the eyes and in the lower extremities for 7 days
• seven days prior he parents noticed his periorbital edema
10days--then prednisone 10mg bid po
Case report
• 4 days later :edema remission • 11days later: urine protein （-）
Thank you