Case report of nephrotic syndrome complicated with chylothorax

Q. Fu, Jian-feng Fan, N. Zhou, Zhi Chen, Xiaorong Liu
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Abstract

对首都医科大学附属北京儿童医院肾脏科收治的1例肾病综合征合并乳糜胸患儿的临床资料进行回顾性分析。患儿,女,13岁,因肾病综合征入院,并胸腔积液,胸腔穿刺液为乳糜样,实验室检查确诊为真性乳糜胸,淋巴管造影提示胸导管出口梗阻。肾活检为肾小球微小病变。经原发病治疗,早期积极抗凝,对症等综合治疗后,患儿预后良好。提示乳糜胸是儿童肾病综合征罕见并发症,在无禁忌证的情况下尽早胸部增强CT及血管超声寻找血栓证据,同时建议行淋巴管造影评估有无淋巴管畸形存在。治疗方面以控制原发病,积极抗凝及对症治疗为主,预后良好。
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肾病综合征并发乳糜胸1例
A retrospective analysis was conducted on the clinical data of a child with nephrotic syndrome complicated with chylothorax admitted to the Kidney Department of Beijing Children's Hospital Affiliated to Capital Medical University. A 13-year-old female patient was admitted to the hospital due to nephrotic syndrome with pleural effusion. The pleural puncture fluid was chylothorax, and laboratory examination confirmed true chylothorax. Lymphangiography revealed obstruction of the thoracic duct outlet. Renal biopsy showed minimal glomerular lesions. After primary treatment, early active anticoagulation, and symptomatic comprehensive treatment, the prognosis of the patient is good. It is suggested that chylothorax is a rare complication of pediatric nephrotic syndrome. In the absence of contraindications, early chest enhanced CT and vascular ultrasound should be performed to search for evidence of thrombosis. It is also recommended to undergo lymphangiography to assess the presence of lymphatic malformations. In terms of treatment, the main focus is on controlling the primary disease, actively anticoagulating, and symptomatic treatment, with a good prognosis.
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来源期刊
中华实用儿科临床杂志
中华实用儿科临床杂志 Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.60
自引率
0.00%
发文量
14243
期刊介绍: Chinese Journal of Applied Clinical Pediatrics ( semi-monthly ) is a core journal of paediatrics under the supervision of China Association for Science and Technology, sponsored by Chinese Medical Association and undertaken by Xinxiang Medical College. Founded in 1986, it is openly circulated both at home and abroad. The journal has several columns, such as Expert Forum, Experimental Research and Paediatric Surgery, which are mainly for paediatric medical workers and medical researchers in hospitals. Its purpose is to reflect the new theories and technologies in paediatric medicine and scientific research at home and abroad, and to promote academic exchanges. Chinese Journal of Applied Clinical Pediatrics is a source journal of China Science Citation Database (CSCD), a core journal of Peking University, a source journal of Chinese science and technology paper statistics (China Science and Technology Core Journals), a core academic journal of RCCSE, a high-quality scientific and technical journal of China, a high-quality scientific and technical journal of China Association for Science and Technology, and a high-quality scientific and technical journal of China Biomedical Science and Technology Association. We have been published in China Biomedical Literature Database (SinoMed), China Knowledge Network, Wanfang Data Knowledge Service Platform, China Academic Journal Abstracts, Scopus Database, Chemical Abstracts (USA), Japan Science and Technology Agency (JSTA) Database, Copernicus Abstracts (Poland), Abstracts of the Centre for Agricultural and Biological Sciences (CABS) of the United Kingdom, Cambridge Scientific Abstracts ProQuest Database, WHO Medical Journal of the Western Pacific Region (WMPR), and WHO Medical Journal of the Western Pacific Region (WMPR) of the United States. We have been included in dozens of authoritative databases at home and abroad, such as WHO Western Pacific Region Index of Medicine (WPRIM), Ullrich's Guide to Periodicals, and so on.
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