Nephrotic syndrome, a prevalent pediatric renal disorder, manifests with significant proteinuria, hypoalbuminemia, oedema, and hyperlipidemia. Complications associated with nephrotic syndrome include infections, ascites, and pleural effusion. Congenital cardiac anomalies, such as Patent Ductus Arteriosus (PDA), can further complicate the management of this condition. In this case report, we present a 2-year-old female patient presenting with generalised oedema, fever, and urinary symptoms. Upon diagnosis, the patient was found to have a first-episode nephrotic syndrome complicated by urinary tract infection, mild ascites, pleural effusion, and incidental PDA. Laboratory tests revealed substantial proteinuria and hypoalbuminemia, which were corroborated by imaging studies. Echocardiography revealed a small PDA with a left-to-right shunt. The patient’s condition improved significantly with the administration of corticosteroids, antibiotics, and supportive therapy. This case underscores the paramount importance of early diagnosis, prompt treatment, and multidisciplinary management in pediatric nephrotic syndrome, particularly when comorbidities are present.
Shil et al. (Wed,) studied this question.