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Vomiting in an infant with congenital nephrotic syndrome: Questions

Toshiyuki Takahashi1, Yasuyuki Sato2, Takeshi Yamazaki2

  • 1Department of Pediatrics, Hokkaido University Hospital, Kita 15-jo Nishi 7-Chome, Kita Ward, Sapporo City, Hokkaido, Japan. t-toshi@med.hokudai.ac.jp.

Pediatric Nephrology (Berlin, Germany)
|October 21, 2016
PubMed

Insights

Congenital nephrotic syndrome (CNS) infants may have a higher risk of hypertrophic pyloric stenosis (HPS). Early intervention for gastric outlet obstruction can improve poor weight gain in these patients.

Area of Science:

  • Pediatric Nephrology
  • Gastroenterology

Background:

  • Congenital nephrotic syndrome (CNS) frequently causes failure to thrive.
  • A prior study noted 12% of infants with CNS had hypertrophic pyloric stenosis (HPS).
  • The association between CNS and HPS remains unclear.

Observation:

  • A 4-month-old girl with CNS presented with poor weight gain.
  • Ultrasound revealed thickened pyloric mucosal/submucosal layers and muscle hypertrophy, preceding typical HPS symptoms.
  • Pyloroplasty was performed to address the gastric outlet obstruction.

Findings:

  • The patient experienced improved weight gain after pyloroplasty.
  • Gastric outlet obstruction may be linked to poor growth in CNS patients.
  • Thickened pyloric antrum tissues could contribute to HPS prevalence in CNS.

Implications:

  • Suspect HPS in CNS infants with poor weight gain, even without classic symptoms.
  • Prompt surgical intervention like pyloroplasty can enhance growth outcomes.
  • Understanding this association may improve management of CNS complications.
Abstract

Keywords:
Congenital nephrotic syndromeFailure to thriveVomiting

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