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CASE STUDY OF

NEPHROTIC SYNDROME
Direct by : Icka Siti Aisah/110170028
Advicer : dr. Irman, Sp.A/dr. Tatan Sp.A/
dr. Ineu, Sp.A

PATIENT IDENTITY Name :N  Age : 10 year old  Sex : Male  Address : Cikulak Kidul  Date of admission : 09 June 2015  Date of examination : 09 June 2015  Mother’s patient : Mrs. D  Age : 36 year old  Address : Cikulak Kidul  Occupation : Housewife  Education level : Elementary School  .

Defecation is no complain. Swelling at start on both periorbital and then bilateral lower ekstremities and abdominal bloating. Swelling since approximately one week ago. Complain accompanied by urination less than usual. Complaints swelling persist and than more severe. and more intense color.HISTORY TAKING Chief Complain : Swelling  Patients come to Polyclinic hospital Waled with her mother for the complain of swelling of the body.  .

but there was no improvement. patient's mother had been went to the clinic for treatment of patients with similar complaints. her child was given medication for kidney in the form of white pulvus  . By the doctor are advised to check the urine and the results according to doctors is kidney disease. according to the patient’s mother.  Also according to the patient's mother had also went to the doctor with swelling complaints.  Previous.Due his complaints were go to the hospital Waled polyclinic child and hospitalized.

 After that suddenly the patient does not continue the treatment for about 2 weeks and then the patient's complaints returned to appeared taken to the Waled hospital. .

 Past      medical history There was history the same as complain like as now There was history of urinary such as tea There was no history to contact with a tuberculosis patient or unknow prolong cough infection patient There was no history of skin infection or another There was history of prolong cough and unheal  Family   history There was no history the same as complain like as patient There was no history the prolong cough infection .

99 .2o C  Weight : 28 Kg  Height : 127 cm  Nutrition Status  BMI/Age • Height/Age • o Body surface : Median : Median : 0.PHYSICAL EXAMINATION General Appearance : Composmentis  Blood Pressure : 130/90 mmHg  Pulse : 98x/minute. equal  Respiration : 21x/minute  Temperature : 36. regular.

not cracles.  Heart : S1. no murmurs and no gallop  . conjunctiva are not edematous and his throat is not red.  Nasal : within normal limits  Ears: within normal limits  Mouth: within normal limits. S2 reguler rhythm.Head  Form: Normocephal. the tooth are not decay • Neck : within normal limits • Thorax : within normal limits  Lun g : Breath sounds vesicular right = left. His eyes are non-injected. Conjunctiva are not anemic. sclera not icteric. not wheezing and not rhonchi.  Eyes: periorbital edema.

non-tender.  He has normal male genitalia with no scrotal edema.  No rashes . Abdomen is soft. shifting dullness (+) No hepatosplenomegaly.  The dorsal surfaces of his hands and lower extremites have pitting edema. He has brisk capillary refill and 2+ pulses. nondistended and without masses.

Urinalysis :  Specific gravity : 1.80 (119-202)  Eritrocyte : 10 (0-1 /uL )  BUN and creatinine are normal limits 2. Complete Blood Count are normal limits 3.030 (1.2g/dL)  Cholesterol of 513.030)  Protein : 100 (≤10 mg/dL)  Serum Albumin of 1.000-1.FURTHER EXAMINATION 1.21 (3.5-5. Rontgen Thorax : Thickening of bronchovascular bundles infiltrates duplex in the bronchial dextra more dominant .

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PROPOSED EXAMINATION Serological ASTO  Mantoux Test  .

DIFFERENTIAL DIAGNOSIS Nephrotic Syndrome  Acute Nephrotic Syndrome  Working Diagnosis  Nephrotic Syndrome .

MANAGEMENT a.25 mg .Bed rest b. General . Medikamentosa  Prednisone 60 mg/sq-meter/day divided in 3-doses for 4 weeks  Diuretics: Furosemide 1-3 mg / Weight / day = 56mg/day furosemide  Albumin Infusion 1 gr / Weight = 28 gr Albumin serum  Captopril 2 x 6.Low-salt diet .

51 Ureum 100 21.Follow 09 11 12 13 14 15 16 17 18 Up jun june june june june june june june june 100 30 e 201 2015 2015 2015 2015 2015 2015 2015 2015 5 Kadar protein urine 500 Tekanan darah ? 130/90 120/90 120/90 110/80 100/60 100/80 100/80 100/80 mmHg mmHg mmHg mmHg mmHg mmHg mmHg mmHg Kreatinin 0.2 .

THANK YOU .