Page 329 - Abstract Book KONIKA 18

Nephrology

P-NEP-021
Clinical Features of Pediatric COVID-19 Patients with Renal Disorder:
Case Series

Wildan Saepul H., Omega Mellyana, Heru Muryawan, Rochmanadji W., Wistiani, Riza Sahyuni, M. S. Anam
Department of Child Health, Faculty of Medicine Universitas Diponegoro, Kariadi General Hospital,
Semarang, Central Java, Indonesia

Abstract
Background COVID-19 has various clinical features, especially in children with existing comorbid such
as renal disorder. Objective To determine the clinical features of covid-19 patients with renal disorders in
children. Cases We reviewed 50 children with confirmed covid-19, but only 7 patients (14%) had renal
disorders consist of 2 patients with nephrotic syndrome, 2 patients acute kidney injury, 1 patient acute on
chronic kidney disease stage III and 2 patients chronic kidney disease stage V. The mean age of the patients
was 11 (SD 5) years, 42% was female and 58% was male. The common symptoms were fever (71%), cough
(57%) and shortness of breath (57%). Other symptoms were oedema, ascites, seizures, diarrhoea, rash,
and sore throat. Proteinuria was present in patients with nephrotic syndrome and acute on chronic kidney
disease stage III. A decreased glomerular filtration rate (GFR) occurred in 5 patients (71%). All patients had
bronchopneumonia from the chest x-ray. One patient got severe bronchopneumonia with the CXR brixia
score 13 (223-123). One patient had low cardiac output syndrome with thrombus in left ventricle. Antibiotic
used for 57% patient with bronchopneumonia. Four of 7 patient (57%) were died. Shock, respiratory failure,
metabolic acidosis and ventricular tachycardia were causes of death. Conclusion The common symptoms of
covid-19 with renal disorders were fever, decreased GFR, cough, shortness of breath and bronchopneumonia.
Covid 19 with renal disorder had high mortality.
Keywords: Covid-19; renal disorder; clinical features

P-NEP-022
Haemolytic Uremic Syndrome Associated with Severe Dengue Infection:
A Rare Case Report

Arvin Leonard Sumadi Jap , Alok Adipurnama 2
1
General Practitioner and Pediatrician , Immanuel General Hospital, Bandung, West Java, Indonesia
2
1
Abstract
Background Dengue fever is a tropical infection, which is a mosquito-borne disease, caused by dengue
virus and spread by Aedes mosquito. The spectrum of disease varies ranging from asymptomatic to a severe
form of dengue infections with or without organ impairment. Renal involvement in dengue is relatively rare
and considered as an atypical manifestation. Objective To report a case of 11-year-old boy with haemolytic
uremic syndrome associated with severe dengue infection. Case An 11-year-old boy was admitted with
history of fever for 3 days with altered consciousness. No history of seizures, vomiting, diarrhoea, and
bleeding manifestation. On examination, his GCS was E4M5V3, somnolent, temperature was 37.7 C, with
o
poor capillary perfusion. On respiratory and abdominal examination, we found sign of pleural effusion,
hepatomegaly, and ascites. Complete blood count test found decreased level of haemoglobin and haematocrit,
thrombocytopenia, hyponatremia, hyperkalemia, increased level of ureum and creatinine serum with decreased
eGFR, and dengue serology IgG was positive. Chest X-ray showed pleural effusion. He was treated with fluid
resuscitation, electrolyte correction, diuretic and steroid. His condition getting better after the treatment. The
patient was diagnosed with severe dengue with dengue encephalopathy, haemolytic uremic syndrome, and
electrolyte imbalance. Conclusion Cases of dengue infection with haemolytic uremic syndrome are rare and
only limited case have been reported. Although haemolytic uremic syndrome is a self-limiting disease with
spontaneous recovery, haemolytic uremic syndrome associated dengue infection should be diagnose early, so
strict monitoring and appropriate management can be planned and life-threatening complications be prevented
Keywords: dengue; encephalopathy; haemolytic uremic syndrome; severe

KONIKA XVIII Abstract Book 281