Articole semnate de acelasi autor in Revista Romana de Pediatrie:

NECROZA TUBULARA ACUTA PRIN ACTIUNEA NEFROTOXICA MEDICAMENTOASA – CAUZA RARA DE SINDROM NEFROTIC LA COPIL

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Magdalena Starcea, Mihaela Munteanu, Radu Russu, Anca Iulia Rotaru, Doina Mihaila and Ingrith Miron

REZUMAT

Sunt prezentate două cazuri de sindrom nefrotic (SN) indus de medicamente cu nefrotoxicitate la nivel tubular, cu evoluţie diferită în contextul maladiilor incriminate etiologic.

Fetiţă în vârstă de 5 luni internată cu SN (dovedit clinic şi biologic) şi insuficienţă renală acută, după o spitalizare în alt servici pentru bronhopneumonie. Fetiţa a fost tratată cu ceftriaxonă şi gentamicină 12 zile. Suspiciunea de SN congenital a fost înlăturată de evidenţierea necrozei tubulare renale în fază de recuperare (biopsie renală). Evoluţia a fost favorabilă în 7 zile sub dializă peritoneală.

Adolescentă de 16 ani cu boală Basedow tratată de 3 ani cu carbimazol. S-a prezentat cu sindrom nefrotic care nu a fost influenţat de corticoterapie. Examenul histopatologic a evidenţiat necroză tubulară toxică, fibroză interstiţială, absenţa leziunilor glomerulare. A fost sistat tratamentul nefrotoxic, s-a practicat tiroidectomie după care edemele s-au redus, dar funcţia renală a continuat să se deprecieze, în condiţiile terapiei nefrotoxice administrată timp de 3 ani.

Concluzii. Necroza tubulară renală exprimată clinic şi biologic prin sindrom nefrotic, însoţit de insuficienţă renală este o situaţie rară la copil; gentamicina şi carbimazolul pot fi incriminate etiologic. Suferinţa renală poate fi ameliorată sau nu prin înlăturarea medicamentului cauzal. Eşecul terapeutic s-a corelat cu durata agresiunii medicamentoase şi evoluţia unor comorbidităţi.

Cuvinte cheie: necroză tubulară, sindrom nefrotic, insuficienţă renală acută

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Magdalena Starcea

DRUG INDUCED ACUTE TUBULAR NECROSIS – RARE CASE OF NEPHROTIC SYNDROME

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Magdalena Starcea, Mihaela Munteanu, Radu Russu, Anca Iulia Rotaru, Doina Mihaila and Ingrith Miron

ABSTRACT

We presented two cases of nephrotic syndrome (NS) drug-induced with tubular nephrotoxicity, with different evolution in the context of etiologic diseases.

First is 5-month-old girl admitted with NS (clinically and biological proven) and acute renal failure after another hospitalization for pneumonia. The girl was treated with ceftriaxone and gentamicin 12 days. Congenital NS suspicion was eliminated by renal biopsy who revealed renal tubular necrosis highlighting recovery phase. The development was favorable in 7 days of peritoneal dialysis.

The second case was 16 years old adolescents treated 3 years with carbimazol for Basedow disease. Was presented with nephrotic syndrome not influenced by corticosteroids. Histopathology revealed toxic tubular necrosis, interstitial fibrosis, absence of glomerular injury. Nephrotoxic treatment was stopped, and, after thyroidectomy, edema were reduced, but kidney function continued to depreciate, while nephrotoxic therapy given for 3 years.

Conclusions. Renal tubular necrosis clinical and laboratory expressed by nephrotic syndrome, accompanied by renal insufficiency is a rare occurrence in children; gentamicin and carbimazol can be criminalized. The suffering or impairment may be improved by removing the causative drug. Treatment failure was associated with duration of drug aggression and evolution of comorbidities.

Keywords: acute tubular necrosis, nephrotic syndrome, acute renal failure

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Magdalena Starcea