Pulmonary tuberculosis in childhood nephrotic syndrome (A cross sectional study)
Abstract
Childhood tuberculosis persists as an important global health problem. Tuberculosis is one of the commonest
important complications in children with nephrotic syndrome. Tuberculosis may interfere with the response to steroid therapy
and is still being the commonest morbidity cause in children with nephrotic syndrome. To find out the prevalence, clinical
features, and the impact of tuberculosis in children with nephrotic syndrome, a cross sectional study was conducted on 100
nephrotic children consisted of 63 males and 37 females at the Cipto Mangunkusumo Hospital from April 1st to October 30th,
1999. Pulmonary tuberculosis was detected on 15 cases ( 95% CI : 8% - 22% ) , consisted of 8 boys and 7 girls. Most of them
aged 10 – 16 years old (66,6%) and 86,7% were undernourished. The combination of clinical judgement, chest X-ray and
Mantoux test were helpful in establishing the diagnosis. The majority of tuberculosis cases (80%) were detected on frequent
relapsers and steroid dependent groups of the nephrotic syndrome. A significant correlation were noted in tuberculosis with
undernutrition and unfavorable response to steroid (frequent relapser and steroid dependent cases).
References
2. International Study of Kidney Disease in Children. Minimal change nephrotic syndrome in children: deaths during the first 5 to 15 years observation. Pediatrics 1984; 73:497- 501.
3. Gulati S, Kher V, Gupta A, Arora P, Rai PK, Sharma RK. Spectrum of infections in Indian children with nephrotic syndrome. Pediatr Nephrol 1995; 9:431-4.
4. Sudra P, ten Dam G, Kochi A. Tuberculosis: global overview of the situation today. Bull WHO 1992; 70: 49-59.
5. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I, Purwanto SH. Perkiraan besar sample. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. Jakarta:Binarupa aksara, 1995.p.187-212.
6. International Study of Kidney Disease in Children. Prospective, controlled trial of cyclophosphamide therapy in children with the nephrotic syndrome. Lancet 1974; 2:423-7
7. International Study of Kidney Disease in Children. Nephrotic syndrome in children: A randomized trial comparing two prednison regimens in steroid responsive patient who relapsers early. J Pediatr 1979;95:239-43
8. Houwert KAF, Borggreven PA, Schaaf HS, Nel E, Donald PR. Prospective evaluation of World Health Organization criteria to assist diagnosis of tuberculosis in children. Eur Respir J 1998; 11: 1116-20.
9. Rahajoe NN. Berbagai masalah diagnosis dan tatalaksana tuberkulosis anak.In: Rahajoe N, Rahajoe NN, Boediman I, et al, editor. Perkembangan dan masalah pulmonologi anak saat ini. Naskah lengkap Pendidikan Kedokteran Berkelanjutan Ilmu Kesehatan Anak XXXIII, FKUI 1994.
Jakarta: Balai Penerbit FKUI, 1994.p.161-81.
10. Inselman LS. Tuberculosis in children: An Update. Pediatric Pulmonology 1996; 21: 101-20.
11. Cercenia BC, Antonio ZL, Soriano RB. Primary tuberculosis in children with idiopathic nephrotic syndrome. Presented at The 6th Asian Congress of pediatric Nephrology, Manila, Philippines, 21-24 April, 1996.
12. Smith MHD, Marquis JR. Tuberculosis and other mycobacterial infections.In: Feigin RD, Cherry JD,editor. Textbook of Pediatric Infectious Diseases. 2nd edition. Philadelphia: Saunders, 1987.p. 1342-87.
13. Chandra RK. Immunocompetence in undernutrition. Pediatrics 1972; 81:1194-200.
14. Gulati S, Kher V, Gulati K, Arora P, Gujral R. Tuberculosis in childhood nephrotic syndrome in India. Pediatr Nephrol 1997; 11: 695-8.
15. Pineda PR, Leung A, Muller NL, Allen EA, Black WA, Fitzgerald JM. Intrathoracic paediatric tuberculosis: a report of 202 cases. Tubercle and Lung Disease 1993; 74: 261-6.
16. Harris RC, Ismail N. Extrarenal complications of the nephrotic syndrome. Am J Kidney Dis 1994; 23:477-97.
17. Kala U, Milner LS, Jacobs D, Thomson PD. Impact of tuberculosis in children with idiopathic nephrotic syndrome. Pediatr Nephrol 1993; 7:392-5.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2017-02-01
Published 2001-04-30