What is An Infant with severe dehydration secondary to diarrhea suddenly presents with proteins and blood in urine. The most probable diagnosis is _______ and explain in detail?
Nephrotic syndrome, a kidney disorder, causes excessive loss of protein in the urine, low levels of albumin in the blood, a high level of cholesterol in the blood and swelling, triggering a hypercoagulable state and increasing chances of clot formation. Other less common causes include hypercoagulable state, cancer, kidney transplantation, Behcet syndrome, antiphospholipid antibody syndrome or blunt trauma to the back or abdomen. Treatment of RVT mainly focuses on preventing fuher blood clots in the kidneys and maintaining stable kidney function. The use of anticoagulants has become the standard treatment in treating this abnormality.Membranous glomerulonephritis, the most common cause for nephrotic syndrome in adults, peaks in people ages 40-60 years old and it is twice as likely to occur in men than in women. Since nephrotic syndrome is the most common cause of RVT, people over 40 years old and men are most at risk to develop a renal vein thrombosis. Renal Vein Thrombosis * The hypercoagulable state of nephrotic syndrome predisposes to renal vein thrombosis (mostly in membranous nephropathy) * Other causes include -- invasion by renal cell carcinoma -- thrombophillia * Clinically -- Often assymptomatic, but may present with loin pain, haematuria, palpable kidney, sudden deterioration in renal function. * Diagnosis -- Doppler USS, CT, MRI or renal angiography (venous phase) * Treatment -- Anticoagulate with warfarin for 3-6 months (until albumin >25g/L) * Target INR is 2-3 Reference: GHAI Essential pediatrics, 8th edition