What is nephrotic syndrome, condition diagnosed in Junior Lima and Monica Benini’s daughter

What is nephrotic syndrome, condition diagnosed in Junior Lima and Monica Benini’s daughter


Rare disease affects the kidneys and is easily confused with allergies

The musician Junior Lima and his wife, Monica Benini, published on social networks that the couple’s daughter, Lara, 3, A nephrotic syndrome has recently been diagnoseda rare picture that affects the kidneys.

The couple said she discovered the conditions of their daughter after she inflated her eyes, which made the family suspect of an allergic image. “His swelling of the eyes. We took a doctor, an allergist, pediatrician … He even took medicines for allergy,” said Monica.

The diagnosis, however, came only after a detailed medical investigation period. Therefore, according to Junior, the decision to speak publicly of the case was destined to warn other families of rare syndromes and the importance of early diagnosis.

What is nephrotic syndrome?

Firstly, it is noteworthy that the difference in disease, a “syndrome” concerns a series of signs and symptoms that occur together and characterize a clinical picture.

In the case of nephrotic syndrome, for example, it represents a typical combination of symptoms that can be caused by kidney disease.

The condition is generally accompanied by a classic trio of signs: “swelling of the body, loss of proteins by the urine and increased cholesterol”, explains the nephrologist pediatric Donizetti Giamberardino Filho, of Little Prince Hospital.

Normally, kidneys filter the blood and maintain proteins that are important for the body. However, when they are damaged or sick, they can allow proteins such as the albumin to pee.



“If you lose them in large quantities, the level of blood proteins also decreases, which leads to liquid retention,” says Filho. Liquid retention, in turn, is what causes swelling (or edema).

Edema usually appears on the face. Over time, it can progress towards the abdomen and the lower limbs, like the legs. “Reference can also lead to an increase in blood pressure”, warns Américo Cuvello Neto, coordinator of the center specialized in nephrology and dialysis Oswaldo Cruz German Hospital.

Causes

The diseases that lead to syndrome are mainly those that cause some changes in the renal filtration membrane. “The main feature of this change is the loss of protein in the urine,” explains Cuvello.

In children, the most common cause of nephrotic syndrome is the minimum disease so called (DLM). In this condition, there are injuries to kidney cells that help filtering blood, which leads to this abnormal protein loss.

Despite this functional problem, in this image, the kidneys have no important changes in their structure, hence the title of “minimum”. The cause of the disease is mostly unknown, which is called “idiopathic”.

“There is no determined source for this disorder. There is a microscopic change that causes, for some reason, there is a significant loss of protein. It is as if the kidney was a sieve that has bigger holes”, illustrates Filho.

Especially in adults, according to Cuvello, the syndrome can also be secondary to systemic diseases that affect the kidneys, such as diabetes. It can cause kidney lesions that lead to the loss of protein and the typical swelling of nephrotic syndrome.

When to suspect the painting? What are the signs?

As stated at the beginning of the relationship, the main symptom is swelling. “The child begins to inflate his eyes in the morning,” describes his son.

In addition, only laboratory tests can show if there are other characteristics of the picture, such as the loss of significant proteins and the increase in cholesterol or blood pressure.

I am underlined that it is very easy to confuse the photo with an allergy, as happened with Junior’s daughter. But the pediatric nephrologist gives some suggestions on how to differentiate them: “The allergy is generally provided with other symptoms such as sneezing, itching, skin lesions,” he says. In addition, another important feature is to observe whether there is an increase in foam in the urine, a warning for excess protein in pee.

Is this syndrome dangerous?

The risk associated with nephrotic childhood syndrome is considered low because, as mentioned, evolution is often benign. “However, complications such as the increase in blood pressure, swelling and, more rarely, the loss of renal function,” says Cuvello.

In more serious or difficult cases, thrombotic phenomena can occur in the veins or arteries of the lower or superior limbs, but this is rare.

How is the diagnosis made?

The diagnosis of nephrotic syndrome is based on the patient’s clinical history and on a series of exams.

Blood exams are performed such as the dosage of proteins, as well as urea and creatinine to evaluate renal function, as well as cholesterol and triglycerides. The urine collection is also performed to evaluate the loss of protein.

In some situations, there may be loss of renal function, which is mainly evaluated by the dosage of creatinine in the blood. If the levels have increased, this can indicate renal dysfunction.

From the results, the treatment is generally started with the indicated medicines. For children, kidney biopsy is considered when there is no response to conventional treatment.

This procedure collects a renal fragment for anatomo-pathological analysis and is considered the most accurate. The examination allows you to identify which disease is causing the syndrome and, from there, define the best treatment.

How is the treatment?

The most common treatment is with corticosteroids. In the end, diuretics can be used. When there is no response to corticosteroids, the use of other immunosuppressive drugs is discussed.

Does syndrome have a cure?

Nefrotic syndrome can have “healing”, but this varies according to the origin of the problem, that is, if the cause can be treated.

In young children, evolution is generally benign: the symptoms improve with the use of medicines and, over time, most patients go to remission. Second child, about 80% of children evolve by healing for 4-5 years.

In adults or older children, the image can be more complex. Nefrotic syndrome can be associated with other kidney diseases, which have a less favorable evolution, with greater possibility of recurrence, the need for more intense treatments and risk of renal function.

In such cases, we do not always talk about “healing” in the definitive sense. “It is different from pneumonia, where you take antibiotics and you are healed,” says Son. “It’s a support treatment, I wouldn’t dare to say he’s healing.” However, control is possible.

Source: Terra

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