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Reversible nephrotic syndrome secondary to pulmonary hydatid disease

Tahar Gargah, Rim Goucha-Louzir, Youssef Gharbi, Rachid Mohamed Lakhoua

Abstract


Most patients with pulmonary hydatidosis are children. The disease may be asymptomatic or revealed by unusual events such as a glomerulopathy.

An 8-year-old boy from a rural part of Tunisia presented with generalised oedema and macroscopic haematuria. There was no familial history of renal disease. He had a normal blood pressure (100/60 mmHg), and a pleural effusion was detected. Urinalysis showed nephrotic range proteinuria (375 mg/kg/d) and microscopic haematuria. His serum total protein concentration was 40 g/l and his serum albumin was 10 g/l. Renal biopsy showed capillary wall thickening and duplication, and mesangial cell proliferation in the glomeruli, characteristic of mesangiocapillary glomerulonephritis. Renal and abdominal ultrasound images showed increased echogenicity of the kidneys and mild ascites. Radiology revealed three large pulmonary hydatid cysts. The largest cyst occupied the entire right upper lobe and compressed the superior vena cava. Hydatid disease was confirmed by a strongly positive serum enzyme-linked immunosorbent assay (ELISA) for echinococcus.

The patient was treated with high protein intake, dipyramidol and captopril; both right lung cysts were resected, followed by the left pulmonary cyst 4 weeks later. Hydatid cyst was confirmed histopathologically. He recovered well, the serum ELISA for echinococcus became negative, and follow-up urine examination and thoracic computerised tomography were normal 6 months after surgery, confirming good renal recovery and absence of pulmonary hydatid disease.

Authors' affiliations

Tahar Gargah, Charles Nicolle hospital

Rim Goucha-Louzir, Charles Nicolle Hospital

Youssef Gharbi, Department of Pediatric surgery, Habib Thameur Hospital

Rachid Mohamed Lakhoua, Charles Nicolle Hospital

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Keywords

Child-hydatid cyst- mesangiocapillary glomerulonephritis-nephrotic syndrome

Cite this article

South African Medical Journal 2010;100(7):424-425.

Article History

Date submitted: 2009-11-23
Date published: 2010-07-02

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