Alwadhi R K, Mathew J L, Rath B
Department of Paediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
J Paediatr Child Health. 2004 Jan-Feb;40(1-2):28-32. doi: 10.1111/j.1440-1754.2004.00285.x.
This is a prospective, hospital based study over a period of one year, to examine the clinical profile of nephrotic children not on glucocorticoid therapy, but presenting with infection.
Sixty-eight children with 76 episodes of nephrotic syndrome were enrolled during the study year. They were examined for evidence of infection using clinical and investigative criteria. The children were monitored daily for proteinuria and improvement of infection. After the infection was controlled, prednisolone therapy was started in those who were not already in remission.
Of the 76 episodes, eight were excluded from analysis as they had developed infection while they were on glucocorticoid therapy. Of the remaining 68 nephrotic episodes in 60 children, there was evidence of infection in 57 episodes (83.8%). Upper respiratory infection was the most common (28.0%) followed by urinary tract infection (22.8%), peritonitis (15.8%), pneumonia (14.0%), acute invasive diarrhoea (10.5%) and empyema (5.3%). Children with infection had significantly lower serum albumin and higher serum cholesterol compared to non-infected children. Of the 57 episodes with infection, remission occurred with control of infection alone in nine episodes (15.8%) and glucocorticoid therapy was not required.
Infection is widely prevalent among Indian children presenting with episodes of nephrotic syndrome, even when they are not on glucocorticoid therapy. Some children may go into remission by control of infection alone. Among the infections, upper respiratory and urinary tract infections are the most common.
这是一项为期一年的前瞻性、基于医院的研究，旨在研究未接受糖皮质激素治疗但出现感染的肾病患儿的临床特征。
在研究年度纳入了68例患有76次肾病综合征发作的儿童。使用临床和检查标准对他们进行感染证据检查。每天监测患儿的蛋白尿情况以及感染的改善情况。在感染得到控制后，对尚未缓解的患儿开始使用泼尼松龙治疗。
在这76次发作中，有8次因在接受糖皮质激素治疗期间发生感染而被排除在分析之外。在60名儿童的其余68次肾病发作中，有57次发作（83.8%）有感染证据。上呼吸道感染最为常见（28.0%），其次是尿路感染（22.8%）、腹膜炎（15.8%）、肺炎（14.0%）、急性侵袭性腹泻（10.5%）和脓胸（5.3%）。与未感染的儿童相比，感染儿童的血清白蛋白显著降低，血清胆固醇显著升高。在57次感染发作中，仅通过控制感染就有9次发作（15.8%）实现缓解，无需糖皮质激素治疗。
即使未接受糖皮质激素治疗，感染在印度患有肾病综合征发作的儿童中也广泛流行。一些儿童仅通过控制感染即可缓解。在这些感染中，上呼吸道感染和尿路感染最为常见。
