Журнал нефрологии и терапии

Врожденный нефротический синдром и сердце: чтобы мы не забыли — Дипанджан Бхаттачарья, Институт последипломного медицинского образования и исследований

Abstract

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????????? ? ??????: ? ??????? 4,2 ??? ? ???????? 2007 ???? ?? ?????? 2011 ???? ? ????? ?????????? ????????? ???? ???????????????? ????? ??????? ??????????? ?????????????? ?????????, ???? ???? ???????? ??????????? ?? 3-?? ??????, ???????????????? (???????????? ????? ????? 2,5 ??????/????????) ? ??????????? ????? 50 ??????????/?????????/???? ? ???????? ???? ????????????? ???????????. ??????, ????????? ? ???????????????????? ? ?????????????? ??????????????? ?????????????, ?????????? ?? ?????? ????????????. ???? ????????? ???????????????, ? ??? ???????? ?????????? ? ?????? ???????????? ????????????? ?????, ????????? ? ?? ????? ???? ???????????????. ?? ????????? ????????? ???? ???????? ??????? ? ?????????????? ???????????? ????????? ?????? ????????????? ??????? ?? ??????? Vingemed ? 2,5 ???????????? ?????? ?? ?????????? ??????????????? ???????????. ?????????? ? ?????? ????? ?????? ??????????? ?? ???????? ??????????? ? ???????????????? ??????? ?????? ? ???????????, ??? ????????????? ??????? ???? ?? ??????? ????? ?????? ?????? ?? ?????????????? ??????????? ? ?? ?????????????? ????? ????? ?????? ?? ?????????????? ??????????? ????????? ??????????????? ?????????? ?????? (???? ????? ?????? ??????? ? ?????? ?????????? 35-50 ??????????? ???????? ??????) ? ????????? (?????? ???????? ????? ?????? ??????? ? ?????? ?????????? ????? 50 ??????????? ???????? ??????), ??????????????? ? ????? ???????????? ??? ??????. ????????????? ?????? ??? ?????????????? ?????? ?? ??????????????? ???????? ?????? ?????????????.

Result: During 4.2 years from September 2007 to 2011, six instances of inherent nephrotic disorder alluded to our emergency clinic as a referral medical clinic. Two out of 6 cases analyzed before age of 2 months and 4 out of 6 preceding third months. All gave ascite, whiteness; edema generally kicked the bucket before age of 4 months because of sepsis and intense renal disappointment. Serum egg whites in all cases were under 2 g/dl (mean: 1.3 gram/deciliter), they were conceived in term or close to term pregnancy (mean: multi week of gestational age and 2900 gram weight of birth), the guardians were not related generally (4/6). Tricuspid spewing forth in moderate evaluations was found in 3/6. Pulmonic stenosis were found in 3/6 , in one case it was valvular in other case it was sub pulmonic stenosis and in third it was in fringe parts of pneumonic supply routes that was missed in first attempt. Left ventricular hypertrophy and mitral disgorging was seen in 2 cases

Discussion: Heart contortion along steroid safe nephrotic condition due to podocin change that have some capacity in cardiovascular improvement has been accounted for much of the time 8 yet its heart affiliation depicted once before in a family comprised of four sisters who created steroid safe inborn nephritic disorder created clinical indication of right ventricular surge plot check. In two of the young ladies, affirmation of right ventricular strain was acquired from electrocardiography and chest radiography. In one of the young ladies subpulmonary right ventricular surge lot hindrance was shown at posthumous assessment. Report of minor cardiovascular contortion in one fourth of Finnish patient with gentle utilitarian pneumonic hypertrophy and stenosis, in other report from Malta serious aspiratory stenosis and subaortic stenosis portrayed. As our investigation heart affiliation are regular in innate nephritic disorder as it appears not being coincidental as in two successive kin complex heart basic imperfections fundamentally pulmonic stenosis saw from non related guardians in spite of the fact that in different examinations cardiovascular assessment frequently uncover ventricular hypertrophy however auxiliary deformities are rare12 yet in 6 consanguineous Arabs family heart oddities were seen due to podocin blend deficiency8 in another examination 2 out of 12 patients had heart irregularities chiefly gentle mitral disgorging and left ventricular hypertrophy 13 yet as our examination a few evaluations of heart imperfections can be seen almost taking all things together, and various basic imperfections can be seen in lesser by and large in familial structure, right ventricular hypertrophy occurred in 1 out of 6 and left ventricular hypertrophy in 2 out of 6 patients yet the most significant finding is pulmonic valve stenosis (valvualr or subvalvular) or it might be occurred in fringe some portion of aspiratory course that might be missed from the start without focusing decisively. Tricuspid spewing forth is another normal issue ascribed to expanded aspiratory hypertension in nephrotic disorder that might be found in 7/8 of steroid safe nephrotic condition with delayed disease14 and in moderate to extreme structure is interesting for pneumonic embolism as an inconvenience of nephrotic syndrome.15 As our investigation tricuspid disgorging saw in 3/6 cases may occurred in age as low as fifteenth days.

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