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Bagri N.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Saha A.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Dubey N.K.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Rai A.,Jawaharlal Institute of Postgraduate Medical Education & Research | Bhattacharya S.,Jawaharlal Institute of Postgraduate Medical Education & Research
Iranian Journal of Kidney Diseases | Year: 2013

Necrotizing fasciitis is a rare complication of nephrotic syndrome in children, with a high mortality rate. We report a case with successful outcome with judicious intravenous antibiotics and skin grafting of the bilateral lower thighs. Source


Suresh C.P.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Saha A.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Kaur M.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Kumar R.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | And 9 more authors.
Clinical and Experimental Nephrology | Year: 2015

Background: We performed a discovery phase of urinary proteomic profile in children with idiopathic nephrotic syndrome and validated selected biomarkers. Methods: Urinary proteomic profile was performed using isobaric tags for relative and absolute quantitation labeling, coupled with liquid chromatography-matrix assisted laser desorption and ionization analysis. Validation of biomarkers apolipoprotein A1, alpha 2 macroglobulin, orosomucoid 2, retinol binding protein 4 and leucine-rich alpha 2-glycoprotein 1 was done by enzyme-linked immunosorbent assay. Results: Apolipoprotein A1 levels of <0.48 µg/mg of creatinine-differentiated steroid-resistant nephrotic syndrome (SRNS) from first episode nephrotic syndrome, area under curve (AUC) [0.99 (CI 0.9–1.0), 100 % sensitivity and 100 % specificity] and a value of <0.24 µg/mg of creatinine could differentiate SRNS from frequently relapsing nephrotic syndrome/steroid dependent nephrotic syndrome [AUC 0.99 (CI 0.9–1.0), 100 % sensitivity and 100 % specificity]. Alpha 2 macroglobulin could differentiate children with SRNS-focal segmental glomerulosclerosis (FSGS) from SRNS-minimal change disease (MCD) at values >3.3 µg/mg of creatinine [AUC 0.84 (CI 0.62–1.0), 90 % sensitivity and 85 % specificity]. Orosomucoid 2 >1.81 µg/mg of creatinine could distinguish SRNS-FSGS from SRNS-MCD [AUC 0.84 (CI 0.62–1.0), sensitivity 90 % and specificity 85.5 %]. RBP 4 value of >1.54 µg/mg of creatinine differentiated SRNS-FSGS from SRNS-MCD [AUC 0.87 (CI 0.68–1.0), sensitivity 90 % and specificity 85.7 %]. Conclusions: Lower level of apolipoprotein A1 in urine is suggestive of SRNS. Alpha 2 macroglobulin, retinol binding protein 4 and orosomucoid 2 are markers associated with FSGS, with alpha 2 macroglobulin being most predictive. © 2015 Japanese Society of Nephrology Source

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