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腎症候群의 臨床病理學的 考察 Clinicopathologic Study of the Nephrotic Syndrome in Children

소아과 1979년 20권 12호 p.17 ~ 26
이승주,
소속 상세정보
이승주 (  ) 
서울대학교 의과대학 소아과학교실

Abstract


This study is aimed to evaluate the clinicopathologic correlation and responsiveness to steroid therapy of individual glomerular morphology. So, percutaneous renal biopsy was performed in every nine patient with nephrotic syndrome which developed in the abscence of any underlying systemic disease, and it is possible to classify idiopathic nephrotic syndrome into several well defined groups of clinieopathologic entities. Of 9 patients, 6 were minimal change lesions, 2 were focal glomerulosclerosis and 1 was mesangial proliferative glomerulonephritis.
There was no correlation between individual glomerular_ morphology and the intensity. of proteinuria, hypoalbuminemia, generalized edema and hypercholesterolemia. But hematuria, azotemia and hypertention were more frequently observed in structural glomerular lesions.
Azotemia or hypertention was noted on each focal glomeruloscerosis and hematuria was noted on one minimal change lesion which was resistant to steroid therapy.
Five of 6 patients with minimal change lesions were sensitive to initial steroid therapy.. Of the 5, two were considered as remission due to no relapse during the follow up from 6 months to one year, and three were considered as frequent relapser with one or two relapses.
One of 2 patients with focal glomerulosclerosis was a global type which was steroid dependant thoughout the course. Another was a segmental type on the initial biopsy and changed to global type along steroid treatment. One patient with focal mesangial proliferative glomerulonephritis was resistant to steroid therapy but had spontaneous remission after the 6 months´ follow up.

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