Les particularités du syndrome néphrotique de l’enfant au Sénégal

Résumé

Introduction: Child nephrotic syndrome (NS) is defined biologically by the association of 24 hours proteinuria (24hrs Pu) 50mg/kg, serum proteins below 60g/l and albumin below 30g/l. Patients and methods: The study was conducted in referral pediatrics centers of two University teaching hospitals of Dakar,from January 2000 to December 2012.Results:A total of 109 childs with NS were included. The NS incidence was higher between March and May (37.6%). The overall median age was 89 months, sex-ratio was 1.7. Edema was constantly present. The mean serum protein was 47.24 g/l and 17.57 g/l for albumin. Creatinine clearance was 114.47 ml/min/1.73m². The mean 24hrs Pu was 113.73mg/kg/24h. NS was pure in 78 children (71.6%) and impure in 31 (28.4%).Seventeen children (16%) had renal biopsy: nine (53%) children had minimal change disease (MCD), four (23%)  had focal and segmental glomerulosclerosis (FSGS), one (6%) diffuse mesangial proliferative glomerulonephritis (MsPGN), one (6%) an association of FSGS and diffuse MsPGN, one (6%) membranous glomerulonephritis MEGN and one (6%) lupus nephritis stage IV.Kidney biopsy indication in 14 children was steroid resistance (14 cases) and in three children their age above 10 years at the time of diagnosis. Eighty five children (78%) were steroid sensitive and 47 (43%) relapsed during the follow-up. Twenty four children (22%) were considered steroid-resistant. Complications were infection (23%) and hypercholesterolemia (96.5%). Conclusion: Epidemiological data available in Senegal could suggest that environmental factors interfere in the setting of child NS.