Nephrotic syndrome differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
The differential diagnosis of nephrotic syndrome includes other | The differential diagnosis of nephrotic syndrome includes other diseases with similar findings on physical examination, such as [[lower extremity edema]], or similar clinical findings, such as [[hypoalbuminemia]]. Differential diagnoses include [[congestive heart failure]], [[liver cirrhosis]], [[protein losing enteropathy]], [[malignancy]], [[lymphedema]], [[venous insufficiency]], and [[malnutrition]]. | ||
==Differentiating Nephrotic Syndrome from other Diseases== | ==Differentiating Nephrotic Syndrome from other Diseases== | ||
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| bgcolor="#d9ff54"|'''Differential Diagnosis''' || bgcolor="#d9ff54"|'''Characteristic Features''' | | bgcolor="#d9ff54"|'''Differential Diagnosis''' || bgcolor="#d9ff54"|'''Characteristic Features''' | ||
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| bgcolor="#ececec"|'''Congestive Heart Failure''' || | | bgcolor="#ececec"|'''[[Congestive Heart Failure]]''' || | ||
*History of cardiovascular disease | *History of [[cardiovascular disease]] | ||
*Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, pitting edema, pulmonary edema | *[[Dyspnea]], [[orthopnea]], [[paroxysmal nocturnal dyspnea]], [[pitting edema]], [[pulmonary edema]] | ||
*Low ejection fraction on echocardiography | *[[Low ejection fraction]] on [[echocardiography]] | ||
*Elevated brain natriuretic peptide (BNP) levels | *Elevated [[brain natriuretic peptide]] (BNP) levels | ||
*Abnormal heart rate | *[[Abnormal heart rate]] | ||
*Third heart sound | *[[Third heart sound]] | ||
*Lung crackles or wheezing | *[[Lung crackles]] or [[wheezing]] | ||
*Elevated jugular venous pressure | *[[Elevated jugular venous pressure]] | ||
*Cardiomegaly with cardiothoracic ratio on | *[[Cardiomegaly]] with cardiothoracic ratio on [[X-ray > 0.5 | ||
|- | |- | ||
| bgcolor="#ececec"|'''Liver Cirrhosis''' || | | bgcolor="#ececec"|'''[[Liver Cirrhosis]]''' || | ||
*Gynecomastia, spider angiomata, testicular atrophy, encephalopathy | *[[Gynecomastia]], [[spider angiomata]], [[testicular atrophy]], [[encephalopathy]] | ||
*Pitting edema and ascites | *[[Pitting edema]] and [[ascites]] | ||
*Normal/elevated liver | *Normal/elevated liver [[transaminase]]s | ||
*Prolonged INR | *[[Prolonged INR]] | ||
*Hypoalbuminemia | *[[Hypoalbuminemia]] | ||
*Shrunken liver on imaging | *Shrunken liver on imaging | ||
|- | |- | ||
| bgcolor="#ececec"|'''Protein Losing Enteropathy''' || | | bgcolor="#ececec"|'''[[Protein Losing Enteropathy]]''' || | ||
*Watery diarrhea | *[[Watery diarrhea]] | ||
*Abdominal pain | *[[Abdominal pain]] | ||
*Weight loss | *[[Weight loss]] | ||
*Hypoalbuminemia and hypoglobulinemia | *[[Hypoalbuminemia]] and [[hypoglobulinemia]] | ||
*Stool alpha-1-antitrypsin | *Stool [[alpha-1-antitrypsin]] | ||
*Imaging and endoscopy findings depend on etiology of enteropathy | *Imaging and endoscopy findings depend on etiology of [[enteropathy]] | ||
|- | |- | ||
|bgcolor="#ececec"|'''Malignancy''' || | |bgcolor="#ececec"|'''[[Malignancy]]''' || | ||
*Weight loss, fever, fatigue | *[[Weight loss]], [[fever]], [[fatigue]] | ||
*Pitting or non-pitting edema with serous exudation, ascites, pleural effusion, pulmonary edema | *Pitting or non-pitting edema with serous exudation, [[ascites]], [[pleural effusion]], [[pulmonary edema]] | ||
*Lymphatic obstruction | *Lymphatic obstruction | ||
|- | |- | ||
|bgcolor="#ececec"|'''Lymphedema''' || | |bgcolor="#ececec"|'''Lymphedema''' || | ||
*History of lymph node resection and/or radiation therapy, especially in breast cancer | *History of lymph node resection and/or [[radiation therapy]], especially in [[breast cancer]] | ||
*Fatigue | *[[Fatigue]] | ||
*Swollen limb with localized fluid accumulation | *Swollen limb with localized fluid accumulation | ||
*Skin discoloration | *[[Skin discoloration]] | ||
|- | |- | ||
|bgcolor="#ececec"|'''Venous Insufficiency''' || | |bgcolor="#ececec"|'''Venous Insufficiency''' || | ||
*Painful extremities | *Painful extremities | ||
*Bluish | *Bluish skin discoloration | ||
*Edema mostly after prolonged standing | *[[Edema]] mostly after prolonged standing | ||
*Stasis dermatitis | *[[Stasis dermatitis]] | ||
|- | |- | ||
| bgcolor="#ececec"|'''Malnutrition''' || | | bgcolor="#ececec"|'''Malnutrition''' || | ||
*Weight loss, fatigue, irritability, dyspnea, and depression | *[[Weight loss, [[fatigue, [[irritability, [[dyspnea, and [[depression | ||
*Menstrual irregularities | *Menstrual irregularities | ||
*Poor wound healing and easy bruisibility | *Poor wound healing and easy bruisibility | ||
*Muscle atrophy and fat wasting | *[[Muscle atrophy]] and [[fat wasting]] | ||
*Dry skin and hair loss | *[[Dry skin]] and [[hair loss]] | ||
*Anemia | *[[Anemia]] | ||
*Hypoalbuminemia | *[[Hypoalbuminemia]] | ||
|} | |} | ||
Revision as of 02:40, 5 April 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian
Overview
The differential diagnosis of nephrotic syndrome includes other diseases with similar findings on physical examination, such as lower extremity edema, or similar clinical findings, such as hypoalbuminemia. Differential diagnoses include congestive heart failure, liver cirrhosis, protein losing enteropathy, malignancy, lymphedema, venous insufficiency, and malnutrition.
Differentiating Nephrotic Syndrome from other Diseases
| Differential Diagnosis | Characteristic Features |
| Congestive Heart Failure |
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| Liver Cirrhosis |
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| Protein Losing Enteropathy |
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| Malignancy |
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| Lymphedema |
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| Venous Insufficiency |
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| Malnutrition |
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