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Journal of the Korean Society of Pediatric Nephrology 2003;7(1): 91-95.
미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례
신윤호, 박지민, 신재일, 김명준, 이재승
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 소아과학교실
4연세대학교 의과대학 진단방사선과학교실
5연세대학교 의과대학 소아과학교실
A Case of Acute Acalculous Cholecystitis Superimposed on the Nephrotic Syndrome
Youn-Ho Shin, Jee-Min Park, Jae-Il Shin, Myung-Jun Kim, Jae-Seung Lee
1Department of Pediatrics, Yonsei University College of Medicine
2Department of Pediatrics, Yonsei University College of Medicine
3Department of Pediatrics, Yonsei University College of Medicine
4Department of Diagnostic Radiology, Yonsei University College of Medicine
5Department of Pediatrics, Yonsei University College of Medicine
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ABSTRACT
The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.
Key words: Nephrotic syndrome | Acute acalculous cholecystitis | Hypoalbuminemia | Gallbladder wall thickening
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