Coagulopathy of childhood Nephrotic syndrome

ABSTRACT

To estimate the levels of plasma protein S [total + free] in nephrotic children in order to assess its contribution to the hypercoagulable state in onephrotic syndrome This work was conducted on 20 children with nephrotic syndrome, their age ranged from 3.5 to 17 years and they were categorized into 2 groups. Group A Consisted of 10 children, they were evaluated during relapse [edema and proteinuria]. Group B Consisted of 10 children, they were evaluated during remission [no edema and proteinuria]. Group C A control group of 15 children. All the children were subjected to the following, total serum proteins, serum albumin, serum cholesterol, blood urea, serum creatinine, complete blood picture, ESR and P.T.T. and plasma protein S level [total and free] by [ELISA]. There is a significant increase of the platelet count in nephrotic patients during relapse compared with either the nephrotic patients in remission and the control group. Morover a significant shortening of P.T.T. was observed in nephrotic patients in relapse compared with those in remission and the control group. The total plasma protein S level was not significantly different in the nephrotic patients in relapse compared with either the nephrotic patients in remission or the control group, while the free plasma P.S level was significantly reduced in nephrotic patients in relapse compared with those in remission and the control group. A significant positive correlation was observed between the free plasma P.S. level and serum albumin in nephrotic patients in relapse, and in remission while a significant negative correlation was detected between the free plasma PS level and serum cholesterol in nephrotic patients in relapse and in remission. The hypercoagulable state in nephrotic children is evidenced by hypercholesterolemia, thrombocytosis, shortened P.T.T. in addition to reduced level of free P.S.