Department of Pediatrics, Angkor Hospital for Children, Samdech Tep Vong Street, Siem Reap, Cambodia.
J Pediatr. 2010 Jan;156(1):76-81. doi: 10.1016/j.jpeds.2009.06.049.
To describe childhood nephrotic syndrome (NS) in Cambodia and to evaluate whether initial presentation or relapse is associated with gastrointestinal parasitic infection.
We reviewed the records of 112 children with NS. A retrospective cross-sectional study compared 99 stool exams from 63 children with NS with 12 365 stool exams from 9495 controls.
The male-to-female ratio was 1.7; the mean age of presentation was 8.95 years--44% were hypertensive, 44% had microscopic hematuria, 40% had eosinophilia, and 41% had acute renal failure; 92.7% were steroid sensitive, 12.7% were steroid dependent, and 8.9% were frequent relapsers. Peritonitis and death were rare outcomes. Giardia lamblia (OR, 3.62; 95% CI, 2.0 to 6.1), Strongyloides stercoralis (OR, 3.59; 95% CI, 1.3 to 8.2), and Hookworm species (OR, 2.57; 95% CI, 1.0 to 5.5) were more likely to be isolated from the children with NS than the controls.
The clinical course of childhood NS in Cambodia is similar to the developed world. Differences at presentation included older age and increased prevalence of microscopic hematuria, hypertension, eosinophilia, and acute renal failure. This study demonstrates an association between G lamblia, S stercoralis, and possibly Hookworm species and the onset of NS.
描述柬埔寨儿童肾病综合征 (NS) 的情况，并评估初次发病或复发是否与胃肠道寄生虫感染有关。
我们回顾了 112 名 NS 患儿的病历。一项回顾性病例对照研究比较了 63 名 NS 患儿的 99 份粪便检查结果和 9495 名对照者的 12365 份粪便检查结果。
男女比例为 1.7；发病时的平均年龄为 8.95 岁——44%为高血压，44%有镜下血尿，40%嗜酸性粒细胞增多，41%急性肾衰竭；92.7%对类固醇敏感，12.7%为类固醇依赖，8.9%为频繁复发。腹膜炎和死亡很少见。蓝氏贾第鞭毛虫（OR，3.62；95%CI，2.0 至 6.1）、粪类圆线虫（OR，3.59；95%CI，1.3 至 8.2）和钩虫（OR，2.57；95%CI，1.0 至 5.5）在 NS 患儿中比在对照组中更有可能被分离出来。
柬埔寨儿童 NS 的临床过程与发达国家相似。发病时的差异包括年龄较大，镜下血尿、高血压、嗜酸性粒细胞增多和急性肾衰竭的发生率较高。本研究表明，蓝氏贾第鞭毛虫、粪类圆线虫和可能的钩虫与 NS 的发病有关。
