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Definition:

Congenital nephrotic syndrome is disorder passed down through families in which a baby develops protein in the urine and swelling of the body. Congenital means it is present from birth.

See also: Nephrotic syndrome



Alternative Names:

Nephrotic syndrome - congenital



Causes, incidence, and risk factors:

Congenital nephrotic syndrome is a very rare form of nephrotic syndrome. It occurs primarily in families of Finnish origin and develops shortly after birth. It is inherited, which means it is passed down through families.

Children with this disorder have an abnormal form of a protein called nephrin, which is found in the kidney.



Symptoms:

Signs and tests:

An ultrasound done on the pregnant mother before birth may show a larger-than-normal placenta. The placenta is the organ that develops during pregnancy to feed the developing baby.

Pregnant mothers may have a screening test done during pregnancy to check for this condition. The test looks for higher-than-normal levels of alpha-fetoprotein in sample of amniotic fluid. Genetic tests should be used to confirm the diagnosis if the screening test is positive.

After birth, the infant will show signs of severe fluid retention and generalized swelling. The health care provider will hear abnormal sounds when listening to the baby's heart and lungs with a stethoscope. Blood pressure may be high. There may be signs of malnutrition.

A urinalysis reveals large amounts of protein and the presence of fat in the urine. Total protein in the blood may be low.



Treatment:

Early and aggressive treatment is needed to control the disorder.

Treatment may involve:

  • Antibiotics to control infections
  • Blood pressure medicines called ACE inhibitors
  • Diuretics ("water pills") to eliminate excess fluid
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin to slow protein build up in the urine

Fluids may be restricted to help control swelling.

Removal of the kidneys, dialysis, and kidney transplant may be recommended.



Support Groups:



Expectations (prognosis):

The disorder commonly results in infection, malnutrition, and kidney failure. It can often lead to death by 5 years of age, and many children die within the first year. Congenital nephrotic syndrome may be successfully controlled in some cases with early and aggressive treatment, including early kidney transplantation.



Complications:

Calling your health care provider:

Call your health care provider if your child has symptoms of congenital nephrotic syndrome.



Prevention:



References:

Nephrotic Syndrome. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap. 527.




Review Date: 7/11/2008
Reviewed By: Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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