RESUMO
A 3-year-old male with steroid-responsive nephrotic syndrome developed a rare complication, sagittal sinus thrombosis during an episode of gastroenteritis, while on steroid therapy. Anticoagulation, as assessed by partial thromboplastin time, was difficult to maintain, despite administering high doses of heparin, infusions of fresh-frozen plasma to provide antithrombin III, and, subsequently, maximum doses of warfarin (0.3 mg/kg per day). Despite these problems the child made a complete neurological recovery.
Assuntos
Síndrome Nefrótica/complicações , Trombose dos Seios Intracranianos/etiologia , Anti-Inflamatórios/uso terapêutico , Anticoagulantes/uso terapêutico , Ventrículos Cerebrais/patologia , Pré-Escolar , Humanos , Masculino , Síndrome Nefrótica/tratamento farmacológico , Prednisolona/uso terapêutico , Trombose dos Seios Intracranianos/diagnóstico , Trombose dos Seios Intracranianos/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
Twenty cases of systemic lupus erythematosus (SLE) in prepubertal children (less than 14 years of age) were seen over a period of 14 years. The male:female ratio was 1:2.3, and the mean age at onset was 9.37 years. Fever with joint involvement was the commonest presenting manifestation (60%), followed by nephrotic syndrome (25%). Notable clinical features included a high incidence of renal involvement (75%), significant hypertension (45%) and reversibility of acute renal failure (2 cases). The other organs and systems involved included: mucocutaneous manifestations (60%), cardiovascular system (30%), respiratory system (25%), neuropsychiatric manifestations (45%), and anemia (75%). Raynaud's phenomenon and thrombocytopenia were rare while leucopenia was not seen in a single patient. Immunological abnormalities noted were 100% positivity for antinuclear antibodies, and 87.5 and 75% positivity for antibodies to double-stranded and single-stranded DNA, respectively. Hypocomplementemia was seen in 75% of patients tested.