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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Nephrotic Syndrome

ON 20/4/12, WE NOTICED A LITTLE PUFFYNESS ON MY 3YRS 6 MONTHS DAUGHTER ‘S FACE ALONGWITH LOW URINE OUTPUT. WE MISSTOOK IT FOR COLD SWELLING AS SHE WAS SUFFERING FROM COUGH & COLD AT THAT PARTICULAR TIME. ON 27/4/12 DOCTOR DIAGONIZED AT AS NEPHROTIC SYNDROME. AT THAT TIME HER BODY WEIGHT WAS 14.3KGS. SHE WAS HOSPITALIZED FROM THE SAME DAY & WAS GIVEN 11.5 ML OF STERIOD (OMNACORTILFORTE),5MG PER 5ML. IN HOSPITAL SHE SUFFERED FROM SEVERE ABDOMINAL PAIN AND NAUSEA. GRADUALLY FROM THE 9TH DAY(5/5/12),HER PROTEIN LEVEL STARTED REDUCING FROM 3+ TO 2+. FROM 10TH DAY ONWARDS URINE OUTPUT INCREASED AND ON 13TH DAY URINE HAD –VE READING. FROM 27TH APRIL’12 TO 7/6/12, SHE WAS GIVEN FULL DOSE OF OMNACORTIL FORTE -11.5ML AND FROM 8TH JUNE’12, SHE STARTED HAVING 6.5 ML EVERY ALTERNATE DAY. AFTER RECEIVING IT FOR 2 DAYS I.E FROM 8TH TO 13TH JUNE’12, WE AGAIN NOTICED PRESENCE OF PROTEIN IN HER URINE. ON 15TH JUNE’12 , IT BECAME 3+ & FROM 27TH JUNE ’12 ONWARDS DOCTOR PRESCRIBED 12ML OMNACORTIL FORTE DAILY & ADVICED US TO WAIT FOR 10 DAYS FOR REMISSION. AT THAT POINT OF TIME HER WEIGHT WAS 17.5 KGS. FROM 22ND JUNE ’12 TO 3RD JULY’12-HER PROTEIN LEVEL FRUCTUALED FROM 4+ TO 3+ AND THEN TO 2+ & REMAIN CONSTANT 2+ FOR 4 CONSUCUTIVE DAYS. ON 4TH JULY, HER PROTEIN LEVEL AGAIN JUMPED TO 4+ AND HER WEIGHT WAS AROUND 18 KGS. SHE HAD SWELLING ON HER FACE AND HER ABDOMINAL DIRTH INCREASED . WE TOOK HER TO ANOTHER NEPHROLOGIST WHO INCREASEDE THE VOLUME OF MEDICINE FROM 12 ML TO 14ML & ASKED US TO OBSERVED HER FOR 5 DAYS. ON 7TH JULY’12 HER PROTIEN LEVEL IS TILL 4+ AND SHE HAS BEEN GIVEN LASISE 40MG TO INCREASE HER URINE OUTPUT AND ALSO ALDDOCTONE 25MG. TODAY HER BP IS 90/60. I HAVE FOLLOWING QUESTION IN MY MIND: 1)IS THE LINE OF TREATMENT OKAY OR DOES YOUR HOSPITAL HAS SOME OTHER REMEDY FOR HER. 2)DOES HER SYMPTOMS INDICATING STERIOD RESISTANCE. 3) IF SO, DO YOU HAVE THERAPY FOR THAT. REQUEST PLEASE GUIDE AND HELP US.
Wed, 14 Oct 2015
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Pediatrician 's  Response
Hi,
You are getting the correct treatment for nephrotic syndrome, it may sometimes take more time for the child to respond. In first episode, steroids are given usually for 12 weeks. If patient has subsequent episodes then treatment is changed. I advice you to continue same medicines and monitor daily weight, urine protein, blood pressure and swelling of eyelids. I hope this has helped you. Take care.
Regards
Dr Deepak Patel, MD Pediatrics
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Suggest Treatment For Nephrotic Syndrome

Hi, You are getting the correct treatment for nephrotic syndrome, it may sometimes take more time for the child to respond. In first episode, steroids are given usually for 12 weeks. If patient has subsequent episodes then treatment is changed. I advice you to continue same medicines and monitor daily weight, urine protein, blood pressure and swelling of eyelids. I hope this has helped you. Take care. Regards Dr Deepak Patel, MD Pediatrics