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Fatal haemorrhagic chickenpox complicating nephrotic syndrome
1Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
The Medical Journal of Malaysia
|December 1, 1993
Summary
A young girl on steroids for nephrotic syndrome developed a fatal, disseminated varicella (chickenpox) infection. This rare, severe complication highlights risks in immunosuppressed patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nephrology
Background:
- Varicella infection (chickenpox) is typically benign in healthy children.
- However, it can be severe and fatal in neonates and immunosuppressed individuals.
- Patients with nephrotic syndrome are at increased risk, particularly those on cyclophosphamide.
Observation:
- A 14-year-old girl with nephrotic syndrome receiving steroid therapy developed a fulminant, disseminated varicella infection.
- Her illness progressed to include bleeding dyscrasia and circulatory collapse.
- This case represents a rare instance of fatal varicella in a child treated with steroids for nephrotic syndrome.
Findings:
- Fulminant, disseminated varicella infection can be fatal in immunosuppressed children.
- Steroid therapy for nephrotic syndrome may increase susceptibility to severe varicella complications.
- Hemorrhagic varicella and associated complications like bleeding dyscrasia can occur.
Implications:
- Clinicians should be vigilant for severe varicella in children with nephrotic syndrome on immunosuppressive therapy.
- Early recognition and management of varicella in this vulnerable population are crucial.
- Further research may be warranted to assess the specific risks associated with steroid monotherapy for nephrotic syndrome and varicella.