Impact of tuberculosis in children with idiopathic nephrotic syndrome

Kala, Udai; Milner, Lawrence S.; Jacobs, David W.; Thomson, Peter D.

doi:10.1007/bf00857548

Cited by 13 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FSGS in Johannesburg has been associated with tuberculosis, although this is not the case in the patients we report. It does suggest that some chronic infections may be related to FSGS in Africa [23]. The peak age of presentation was 5 -7 years, with more females than males in all races, differing from data published previously [14].…”

Section: Discussioncontrasting

confidence: 64%

Nephrotic syndrome in South African children: changing perspectives over 20 years

Bhimma

Coovadia

Adhikari

1997

Pediatric Nephrology

View full text Add to dashboard Cite

We review our 20-year experience of 636 children with nephrotic syndrome (NS) in Durban, South Africa; 306 (48.2%) were blacks, 307 (48.2%) Indians and 23 (3.6%) were a mixed group (coloured); 91 (14.3%) could not be categorised and were excluded from the analysis. In Indian children, 134 of 286 (46.8%) had biopsy-proven minimal change NS (MCNS) and 94.8% of these were steroid sensitive (SS); 60 (21%) had SSNS but without renal biopsy; 59 (20.6%) had focal segmental glomerulosclerosis (FSGS), with only 4.4% of these being SS. In blacks, membranous nephropathy accounted for 40% of cases; 86.2% were associated with hepatitis B virus antigens. Typical SSNS continues to be uncommon among blacks. Only 14.4% had either biopsy-proven SS-MCNS or SSNS; 32 had MCNS lesions on biopsy, but 18 were steroid resistant (SR); 67 of 236 (28.4%) had FSGS, all of whom were SR. Among coloured patients, 5 of 23 (21.7%) had biopsy-proven SS-MCNS and or unbiopsied SSNS; 10 (43.5%) had FSGS and 6 of 23 (26.1%) had membranous nephropathy. Proliferative lesions were present in only 2 of 23 (8.6%) coloured patients and was uncommon in all population groups. Overall mortality was 3.1%. In brief, this is the largest reported series of NS among children in Africa and shows a typical pattern in Indians, an unusual pattern of histological types in blacks and an intermediate picture in coloureds.

show abstract

Section: Discussioncontrasting

confidence: 64%

Nephrotic syndrome in South African children: changing perspectives over 20 years

Bhimma

Coovadia

Adhikari

1997

Pediatric Nephrology

View full text Add to dashboard Cite

show abstract

“…It has been previously reported that the occurrence of tuberculosis in the nephrotic syndrome may interfere with the response to steroid therapy and may also have a detrimental effect on renal function [6]. In our study, at the time of diagnosis of tuberculosis, 15 children were in remission and 13 in relapse.…”

Section: Discussionmentioning

confidence: 60%

“…This is much higher than the 1% prevalence in the general population [4]. There have been few previous reports of the occurrence of tuberculosis in patients with nephrotic syndrome [5,6]. This could be because most studies of infections in the nephrotic syndrome are from developed countries where tuberculosis is not common in the general population.…”

Section: Discussionmentioning

confidence: 77%

“…Tuberculosis is a common infection in children in this part of the continent [3,4], which may occur after the onset, of nephrotic syndrome as a result of the immunosuppressed state. Tuberculosis may interfere with the response to steroid therapy and/or accelerate the progression of renal failure in these patients [5,6]. Some patients with tuberculosis may develop nephrotic syndrome secondary to amyloidosis.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Tuberculosis in childhood nephrotic syndrome in India

et al. 1997

View full text Add to dashboard Cite

We studied the prevalence, clinical features, and impact of tuberculosis (TB) on children with nephrotic syndrome (NS). Of the 300 children with NS, 28 (9.3%) were diagnosed as having TB. This occurred following the initiation of immunosuppressive therapy in 27 children, and in 1 child it preceded the onset of NS. Pulmonary involvement was the commonest (22/28), followed by tubercular lymphadenitis (2/28), meningitis (2/28), and occult TB (2/28). Of the various diagnostic criteria, history of previous cough, fever, or exposure to a case of TB (23/28) and chest skiagram (21/28) were the most useful. The occurrence of TB did not induce a relapse or affect the subsequent response to steroid therapy (as is often seen with other infections) or have a deleterious effect on renal function. Patients who received higher doses of steroids (frequent relapsers, steroid dependent, initial non-responders, and subsequent non-responders) had a significantly higher prevalence of TB (19/148) than those who received lower doses (infrequent relapsers 8/151) (P = 0.04). We thus found TB to be an important complication of children with NS in our country. The conventional diagnostic tests, such as Mantoux and acid-fast bacilli isolation, are often unhelpful in these children, and a high index of suspicion is required, especially in children who require frequent courses of steroid therapy.

show abstract

“…16 The high prevalence of UTI found in the study and its complications mandates its aggressive treatment. 26 It is therefore very important that routine urine cultures and sensitivity should be done on patients with nephrotic syndrome in both first attack and relapse cases. The irreverent practice of self-medication, use of substandard drugs, antibiotic misuse and drug abuse is also stand by for this unfortunate trend.…”

Section: Discussionmentioning

confidence: 99%

To study the frequency, etiology and predisposing factors of urinary tract infection in children with nephrotic syndrome in Eastern Odisha Region: a hospital based study

Dash

Bisoi

Mohanty

et al. 2016

Int J Contemp Pediatr

View full text Add to dashboard Cite

Background: The increased prevalence of infection in nephrotic syndrome is due to immunoglobulin loss, defective T cell function, and presence of ascites, relative malnutrition, and immunosuppressive therapy and associated with other factors. The objective of this study was to study the incidence, aetiology and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS).Methods: A retrospective hospital-based study carried out in IMS and SUM Hospital, Bhubaneswar, India. Seventy six children aged between two to twelve years with a diagnosis of NS at the time of were studied from April 2014 to March 2016.Results: The mean age of males was 5.9±0.5years and females are 6.2±0.8years. Pyuria was noted in 44 (57.89%) of the patients. Boys were more commonly affected with urinary tract infection than girls with a ratio of 1.9:1. UTI is the most common encountered infection and was predominantly caused by E. Coli in 18 (39%), Klebsiella species 7 (15.21%) and culture negative in 8 (17.28%) cases. There was high in vitro resistance of these organisms to cefixime and ampicillin but sensitive to cefotaxime, amikacin, ceftriazone , piperacillin- tazobactum and vancomycin.Conclusions: It is recommended that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate taking into account of etiology and predisposing factors. UTI is one of the most common infections accompanying NS due to many factors. A high index of suspicion and early institution of appropriate antibiotics will help in reducing morbidity and mortality.

show abstract

Impact of tuberculosis in children with idiopathic nephrotic syndrome

Cited by 13 publications

References 22 publications

Nephrotic syndrome in South African children: changing perspectives over 20 years

Nephrotic syndrome in South African children: changing perspectives over 20 years

Tuberculosis in childhood nephrotic syndrome in India

To study the frequency, etiology and predisposing factors of urinary tract infection in children with nephrotic syndrome in Eastern Odisha Region: a hospital based study

Contact Info

Product

Resources

About