Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 3873 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
 

Table of Contents   
LETTER TO THE EDITOR  
Year : 2016  |  Volume : 27  |  Issue : 1  |  Page : 177-178
Nephrotic syndrome and situs inversus - A chance association?


201, M-5, C-Wing, Palm Acres CHS, Pratiksha Nagar, Sion, Mumbai - 400 022, India

Click here for correspondence address and email

Date of Web Publication15-Jan-2016
 

How to cite this article:
More VB, Saxena A, Sharma R. Nephrotic syndrome and situs inversus - A chance association?. Saudi J Kidney Dis Transpl 2016;27:177-8

How to cite this URL:
More VB, Saxena A, Sharma R. Nephrotic syndrome and situs inversus - A chance association?. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2019 Nov 12];27:177-8. Available from: http://www.sjkdt.org/text.asp?2016/27/1/177/174215
To the Editor,

A 3-year-old girl was brought with complaints of generalized edema and decreased urine output. She had a history of similar complaints more than six months earlier for which she had responded to the treatment given by a local pediatrician. Her vital parameters were normal. She complained of generalized edema and abdominal distension and her heart sounds were better heard on the right side. No murmur was heard. The liver was just palpable on the left and the spleen was not palpable. Her urine albumin to creatinine ratio was more than 0.2 g. The urine albumin on fresh morning sample was 4+ and she had high serum cholesterol of 345 mg/dL. Her chest X-ray confirmed the presence of dextrocardia [Figure 1]. A 2D-echo revealed dextrocardia with a normal heart and ultrasound of the abdomen revealed situs inversus with an anatomically normal spleen.
Figure 1: X-ray of the chest and abdomen showing dextrocardia with liver shadow on the left side.

Click here to view


After ruling out tuberculosis and hepatitis B, the patient was started on steroids in the form of oral prednisolone at a dose of 60 mg/m 2 / day. After seven days of treatment, the patient went into remission and the steroids were continued for six weeks, followed by alternateday steroids for another six weeks. The patient is on regular follow-up in our nephrology outpatient department and remains in remission.

Dextrocardia with situs inversus is rarely reported with nephrotic syndrome, although various other congenital malformations have been reported. We found a report of dextrocardia with focal and segmental glomerulosclerosis (FSGS) reported in an adult patient with nephrotic syndrome. [1] But, beyond this, there are no reports of nephrotic syndrome being associated with dextrocardia and situs inversus.

Situs inversus is a rare condition and is associated with many other congenital malformations. [1] The other congenital anomalies associated with nephrotic syndrome are hydronephrosis and hydroureters, which are also seen in FSGS. A kidney biopsy has not been performed in our patient as she is an infrequent relapser and hence is more likely to have minimal change disease. Transforming growth factor-beta superfamily molecules have been said to play a major role by affecting the cell by signaling through type I and II serine/ threonine kinase receptors. They are said to be responsible for both nephritic syndrome and situs inversus totalis in an 18-year-old adult female who was steroid sensitive, like our patient. [2]

Conflict of Interest: None declared.

 
   References Top

1.
Vikrant S, Kumar S, Raina R, Sharma A. Nephrotic syndrome in a patient with situs inversus totalis. Clin Exp Nephrol 2008;12: 215-8.  Back to cited text no. 1
    
2.
Domanski M, Domanski L, Ciechanowski K. Nephrotic syndrome and situs inversus viscerum: Correlation or coincidence. J Nephrol 2005;18: 623-5.  Back to cited text no. 2
    

Top
Correspondence Address:
Dr. Vaishali B More
201, M-5, C-Wing, Palm Acres CHS, Pratiksha Nagar, Sion, Mumbai - 400 022
India
Login to access the Email id


DOI: 10.4103/1319-2442.174215

PMID: 26787592

Rights and Permissions


    Figures

  [Figure 1]



 

Top
   
 
 
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  
 


 
    References
    Article Figures
 

 Article Access Statistics
    Viewed1215    
    Printed6    
    Emailed0    
    PDF Downloaded199    
    Comments [Add]    

Recommend this journal