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Primary Peritonitis in Children with Nephrotic Syndrome.

Journal of the Korean Pediatric Society 1985;28(7):695-704.
Published online July 31, 1985.
Primary Peritonitis in Children with Nephrotic Syndrome.
Hae Il Cheong, Whan Jong Lee, Jeong Kee Seo, Yong Choi, Kwang Wook Ko
Department of Pediatrics, Collegof Medicine, Seoul National University
소아 신증후군 환아에 있어서의 원발성 복막염
정해일, 이환종, 서정기, 최 용, 고광욱
서울대학교 의과대학 소아과학교실
Thirty episodes of primary peritonitis in 22 children with nephrotic syndrome who had admitted in the Department of Pediatrics, Seoul National University Hospital from Jan. *81 to Sept. ’84 were studied, and the results were as follows; 1)Among 22 children, male to female ratio was 16 : 6 and the mean age at the onset of peritonitis was 7.80 years (average 2.13 years after the onset of nephrotic syndrome). 2)Peritonitis was not significantly more common in any morphologic subtype of nephrotic syndrome. 3)Major symptoms of peritonitis were abdominal pain(96.7%), fever(93.3%), abdominal tenderness(93.3%) and abdominal rebound enderness(80.0%), and these symptoms were not masked by steroids. 4)Among the causative agents, Streptococcus pneumoniae was the most common one(53.3 % in ascites culture and 81.8% in blood culture), and E. coli was the next(20.0% in ascites culture and 9.1% in blood culture). 5)Serum IgG levels were significantly lower in children with peritonitis than in control children with minimal change nephrotic syndrome, and a transient decrease of serum C3 levels was observed in 1/3 of cases. 6)In 5 children(22.7%), peritonitis recurred more than once. 7) Of 22 children with peritonitis, 3(13.6%) expired with the findings of associated pneumococcal septicemia.
Key Words: Primary peritonitis, Childhood nephrotic syndrome, Pneumococcus, Serum immunoglobulin levels, Serum complement levels

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