Childhood Kidney Diseases (Oct 2018)

A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma

  • Soo Hyun Kim,
  • Hyun-Min Park,
  • Joo Hoon Lee,
  • Hyery Kim,
  • Heounjeong Go,
  • Dae Yeon Kim,
  • Young Seo Park

DOI
https://doi.org/10.3339/jkspn.2018.22.2.91
Journal volume & issue
Vol. 22, no. 2
pp. 91 – 96

Abstract

Read online

Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

Keywords