Trombocytosis in childhood relapsing nephrotic syndrome
Keywords:
thrombocytosis, steroid, frequent relapses nephrotic syndrome, infrequent relapses nephrotic syndrome
Abstract
Background Thrombosis is a serious complication of nephroticsyndrome (NS). Long-term steroid treatment may induce
thrombocytosis in relapsing NS that may predispose to thrombosis.
Most children with idiopathic NS respond to steroids; however, a
substantial number of patients will relapse frequently and require
repeated high dose steroid therapy, thus increase the risk of
thrombocytosis.
Objective To compare the occurrence of thrombocytosis between
children with frequent relapses of NS (FRNS) and those with
infrequent relapses (IFRNS).
Methods We reviewed the medical records of children aged 1-14
years diagnosed as FRNS and IFRNS at the Department of Child
Health, Hasan Sadikin General Hospital Bandung from 2000-
2005. We excluded children with iron deficiency anemia,
hemolytic anemia, acute haemorrhage, malignancy, and those who
received cyclophosphamide.
Results There were 33 children (26 males, 7 females) with FRNS
and 33 children (27 males, 6 females) with IFRNS. The mean
platelet level of children with FRNS (517,909+165,670/ml) was
higher than that of children with IFRNS (416,272+145,763/ml)
(P=0.005). The occurrence of thrombocytosis in children with
FRNS (18) was higher than that of children with IFRNS (7)
(P=0.005).
Conclusion This study shows that thrombocytosis is more
common in FRNS than IFRNS, therefore we should take more
precaution to the occurrence of thrombosis in FRNS.
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2. Siddiqi A. Renal vein thrombosis. Cited 2005 October 30.
Available from: url: http://www.emedicine.com/radio/
topic887.htm
3. Haycock G. The child with idiopathic nephrotic syndrome.
In: Nicholas JA, Postlethwaite RJ, editors. Clinical paediatric
nephrology. 3 th ed. New York: Oxford; 2003. p. 341-66.
4. Anand NK, Chand G, Talib VH, Cheellani H, Pande J.
Hemostatic profile in nephrotic syndrome. Indian Pediatric
1996;33:1005-12.
5. Williams WJ. Secondary thrombocytosis. In: Beutler E, Lichtman
MA, Coller BS, Kipps TJ, editors. Williams hematology. 5 th ed.
New York: Mc-Graw-Hill Inc; 1995. p. 1361-3.
6. Clark AG, Barratt TM. Steroid responsive nephrotic
syndrome. In: Barrat TM, Avner ED, Harmon WE, editors.
Pediatric nephrology. 4 th ed. Baltimore: Lippincott Williams
& Wilkins; 1999. p. 731-47.
7. Hogg RJ, Portman RJ, Miliner D, Lemley KV, Eddy A,
Ingelfinger J. Evaluation and management of proteinuria and
nephritic syndrome in children, recommendation from a
pediatric nephrology panel established at the national kidney
foundation conference on protenuria, albuminuria, risk,
assessment, detection, and elimination (PARADE).
Pediatrics 2000;105:1242-9.
8. Vogt BA, Avner ED. Nephrotic syndrome. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Nelson textbook of
pediatrics. 17 th ed. Philadelphia: WB Saunders; 2004. p.
1753-7.
9. Sutor AH. Thrombocytosis. In: Lilleyman JS, Hann IM,
Blanchette VS, editors. Pediatric hematology. 2 th ed. London:
Churchill Livingstone; 2000. p. 455-64.
10. Wasilewska AM, Zoch-Zwierz WM, Tomaszewska, Biernacka
A. Platelet-derived growth factor and platelet profiles in
childhood nephrotic syndrome. Ped Nephrol 2005;20:36-41.
11. Grimbert P, Audard V, Remy P, Lang P, Sahali D. Recent
approach to the pathogenesis of minimal-change nephrotic
syndrome. Nephrol Dial Transplant. 2003;18:245-8.
12. Inoue S. Thrombocytosis. Cited 2005 October 31. Available
from: url: http://www.emedicine.com/ped/topic2238.htm
13. Schafer AI. Current concepts thrombocytosis. NEJM
2004;350:1211-9.
14. Crow MK. Mechanism of glucocorticoid action on the
immune system and in inflammation. In: Lin AN, Paget SA,
editors. Principles of corticosteroid therapy. London: Arnold;
2002. p. 41-65.
15. Paget SA. Clinical use of corticosteroids: an overview. In:
Lin AN, Paget SA, editors. Principles of corticosteroid
therapy. London: Arnold; 2002. p. 6-16.
Published
2007-07-01
How to Cite
1.
Hafni A, Hilmanto D, Rachmadi D, Sekarwana N. Trombocytosis in childhood relapsing nephrotic syndrome. PI [Internet]. 1Jul.2007 [cited 19Apr.2024];47(3):100-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/353
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Received 2016-08-25
Accepted 2016-08-25
Published 2007-07-01
Accepted 2016-08-25
Published 2007-07-01
