Nephrotic syndrome of acute onset with hypovolaemia.

Abstract

SummaryA male patient, aged 21 years, presented with abrupt onset of circulatory failure one month after the prophylactic administration of antitetanic serum. This patient developed a typical uncomplicated nephrotic syndrome and was subsequently maintained for two years on continuous corticosteroid therapy.The acute onset of circulatory failure was due to grossly depleted plasma protein, with massive proteinuria and plasma volume reduced to 35% of normal. This is discussed with reference to the usual reduced plasma protein concentration and plasma volume in the nephrotic syndrome, which adjusts itself gradually to achieve an equilibrium. Corticosteroid therapy appeared to decrease the permeability of the glomerular membrane for protein.