Nephrotic Syndrome, persistant vomiting, anuria and hypotension

Ridwan, aged 8 years, is a case of Nehrotic Syndrome. He is suffering from NS since the age of 3 years. He has repeated attacks over the years. This is his 8th relapse. He is a case of Minmum Change Nephrotic Syndrome.



Each time he responded to oral prednisolone. But this time he develops persistant vomiting . Vomiting is so severe that he develops anuaria which is partly contributed by low albumin in his blood.

We admitted the patient in the hospital and investigate. His serum electrolytes reflected hyponatrimia, hypochloramia and hypokalamia.

We exclude any infection and peritonitis. We conclude that the vomiting is prednisolone induced.

We stop the drug and switch over to I/V Methyl Prednisolone. He has kept on Methyl Prednisolone for 10 days.

We also have to give him I/V albumin for 3 days as the diuretics are not enough to induce urination.

When vomting stops and the patied sattled and urine become albumin free, we switch over to oral prednisolone and discharge the patient from the hospital.



Bdoza