Page 327 - Abstract Book KONIKA 18

Nephrology

P-NEP-017
Renovascular Hypertension in Adolescent Girl with Mosaic Turner Syndrome:
A Case Report

Irene Ramadhani Putri , Aman B. Pulungan , Henny Adriani Puspitasari 1,2
1,2
1
1
Pediatric Department, Pondok Indah Hospital and Department of Child Health, Faculty of Medicine
2
Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital , Jakarta, Indonesia
Abstract
Background Turner syndrome is chromosomal disorder in female which one of X chromosome is absent or
partially absent and occur in 1: 2.000-2.500 live female birth. The risk of cardiovascular associated disease
increases in Turner patient and significantly worsen its morbidity and mortality. Hypertension can present
from childhood and is reported in 20-40% of pediatric Turner patient. Objective To describe our experience in
diagnosing and managing renovascular hypertension in mosaic Turner syndrome patient. Case A 14-year-old
patient with Turner syndrome with mosaic karyotype 45,X[24]/46,X,r(X)[16] and renovascular hypertension
is presented. She was diagnosed as Turner syndrome at the age of 10 years. She received growth hormone
and hormone replacement therapy for respectively 2- and 4-years duration. During outpatient follow up,
she had elevated blood pressure and overweight with BMI in P94 (CDC NCHS 2000). Complete diagnostic
procedures and target organ damage investigations confirmed the renovascular etiology of the existing
hypertension without target organ complications. Kidney vascular doppler ultrasound reported increase in
resistance index of both renal arteries. Further CT angiogram showed right accessories renal artery stenosis.
Initially, ramipril was administered and subsequently switched to bisoprolol. She managed to control her
clinical blood pressure below P90 with single antihypertensive agent. Although the etiology of hypertension
in Turner’s syndrome has not been fully understood, thorough diagnostic evaluation should be carried out
to investigate renovascular etiology. Conclusion A thorough diagnostic and management evaluation should
be carried out to investigate renovascular hypertension in Turner syndrome,
Keywords: Turner syndrome; renovascular hypertension; accessories renal artery stenosis

P-NEP-018
Steroid Therapy in Nephrotic Syndrome with Confirmed COVID-19:
A Case Report
Jessica E. Ginting, Rosmayanti S. Siregar, Oke R. Ramayani, Ayodhia P. Pasaribu
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara/Adam Malik General Hospital,
Medan, North Sumatera, Indonesia
Abstract
Background Nephrotic syndrome is the most common primary glomerular disease among children.
Approximately 80% of children achieve complete remission with 4 weeks of corticosteroid therapy. In patients
with symptomatic COVID-19, the decision to continue or modify immunosuppression should be made on an
individual basis and should consider the severity of the underlying disease. Objective To see the response of
steroid therapy in children with nephrotic syndrome accompanied by COVID-19 infection. Case A girl, aged
12 years old came with chief complaint swelling of the whole body. Fever, cough and shortness of breath
was found. Urination was cloudy and foamy. The patient was tested for COVID-19 and found a positive
result. Urinalysis found +2 protein with hypoalbuminemia. The patient was given antiviral therapy with
favipiravir 1200 mg on the first day followed by 600 mg/12 hours on the 2nd to 5th day, methylprednisolone
16 mg 2-2-1, spironolactone 12.5 mg, furosemide 20 mg. In the second week of monitoring the clinical
has improved, the swelling was decreased. The protein urinalysis was negative. Conclusion Oral full-dose
steroid administration was effective in controlling the nephrotic syndrome without clinical worsening in
our patient and may be effective for managing nephrotic syndrome accompanied by COVID-19 infection.
Keywords: nephrotic syndrome; COVID-19; steroid

KONIKA XVIII Abstract Book 279