Pediatric nephrology (Berlin, Germany) · 2017
Atypical thymic carcinoid manifesting with nephrotic-range proteinuria in a 7-year-old boy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Soltysiak Jolanta, Ostalska-Nowicka Danuta, Zaorska Katarzyna, Sterzyńska Karolina, Derwich Katarzyna, Zachwieja Jacek
Аннотация
BACKGROUND: Nephrotic-range proteinuria as a paraneoplastic syndrome (PNS) is an exceptional presentation, especially in children. It is usually associated with hematologic malignancies. Solid tumors are very rare causes of proteinuria.
CASE-DIAGNOSIS/TREATMENT: We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD). Tests for a neuroendocrine tumor were performed due to symptoms of hypercortisolemia and an elevated concentration of chromogranin A in the serum. The chest computed tomography revealed a tumor in the anterior mediastinum, which was diagnosed as an atypical thymic carcinoid. A complete resolution of the nephrotic-range proteinuria was observed within 1 week after the first thoracoscopic surgery, with almost complete reduction of the tumor mass.
CONCLUSIONS: This extremely rare case shows that MCD can occur as a PNS even in children. Nephrotic-range proteinuria can be a symptom of malignant solid tumor. This case highlights the possibility of secondary causes of MCD in children.
CASE-DIAGNOSIS/TREATMENT: We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD). Tests for a neuroendocrine tumor were performed due to symptoms of hypercortisolemia and an elevated concentration of chromogranin A in the serum. The chest computed tomography revealed a tumor in the anterior mediastinum, which was diagnosed as an atypical thymic carcinoid. A complete resolution of the nephrotic-range proteinuria was observed within 1 week after the first thoracoscopic surgery, with almost complete reduction of the tumor mass.
CONCLUSIONS: This extremely rare case shows that MCD can occur as a PNS even in children. Nephrotic-range proteinuria can be a symptom of malignant solid tumor. This case highlights the possibility of secondary causes of MCD in children.
Предметные рубрики MeSH
Adrenocorticotropic HormoneBiopsyCarcinoid TumorChildChromogranin ACushing SyndromeDiagnosis, DifferentialHumansHydroxyindoleacetic AcidHyperglycemiaHypernatremiaHypertensionHypokalemiaKidneyMagnetic Resonance ImagingMaleMicroscopy, ElectronNephrotic SyndromeParaneoplastic SyndromesProteinuriaRare DiseasesThoracoscopyThymus NeoplasmsTomography, X-Ray Computed