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      Congenital nephrotic syndrome as a complication of whooping cough: a case report

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          Abstract

          Bordetella organisms are responsible for whooping cough, which is an extremely contagious respiratory illness with substantial morbidity in infants. It is also considered one of the 10 predominant reasons for childhood decease globally, particularly before vaccination was available. Congenital nephrotic syndrome (CNS) presents within the first 3 months of life. It is classified as primary or as secondary to other etiologies, such as infections, drug reactions, toxins, mercury exposure, diabetes mellitus and autoimmune diseases. This article describes the rare presentation of CNS as an outcome to Bordetella infection. That is treating pertussis resulted in CNS to resolve, so it was classified as secondary. This case is the first documented in Syria and the second worldwide.

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          Pertussis leukocytosis: mechanisms, clinical relevance and treatment.

          The significant and sometimes dramatic rise in the number of circulating white blood cells (leukocytosis) in infants suffering from pertussis (whooping cough) has been recognized for over a century. Although pertussis is a disease that afflicts people of all ages, it can be particularly severe in young infants, and these are the individuals in whom leukocytosis is most pronounced. Very high levels of leukocytosis are associated with poor outcome in infants hospitalized with pertussis and modern treatments are often aimed at reducing the number of leukocytes. Pertussis leukocytosis is caused by pertussis toxin, a soluble protein toxin released by Bordetella pertussis during infection, but the exact mechanisms by which this occurs are still unclear. In this minireview, I discuss the history of clinical and experimental findings on pertussis leukocytosis, possible contributing mechanisms causing this condition and treatments aimed at reducing leukocytosis in hospitalized infants. Since recent studies have detailed significant associations between specific levels of pertussis leukocytosis and fatal outcome, this is a timely review that may stimulate new thinking on how to understand and combat this problem.
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            History of Nephrotic Syndrome and Evolution of its Treatment

            The recognition, evaluation, and early treatment of nephrotic syndrome in infants and children originate from physicians dating back to Hippocrates. It took nearly another 1000 years before the condition was described for its massive edema requiring treatment with herbs and other remedies. A rich history of observations and interpretations followed over the course of centuries until the recognition of the combination of clinical findings of foamy urine and swelling of the body, and measurements of urinary protein and blood analyses showed the phenotypic characteristics of the syndrome that were eventually linked to the early anatomic descriptions from first kidney autopsies and then renal biopsy analyses. Coincident with these findings were a series of treatment modalities involving the use of natural compounds to a host of immunosuppressive agents that are applied today. With the advent of molecular and precision medicine, the field is poised to make major advances in our understanding and effective treatment of nephrotic syndrome and prevent its long-term sequelae.
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              Author and article information

              Journal
              Oxf Med Case Reports
              Oxf Med Case Reports
              omcr
              Oxford Medical Case Reports
              Oxford University Press
              2053-8855
              February 2020
              28 February 2020
              28 February 2020
              : 2020
              : 2
              : omaa007
              Affiliations
              [1 ] Student at Faculty of Medicine , University of Aleppo, Aleppo, Syria
              [2 ] Chief of the Department of Pediatrics , Aleppo University Hospital, Aleppo, Syria
              [3 ] Resident doctor at the Department of Pediatrics , Aleppo University Hospital, Aleppo, Syria
              Author notes
              Correspondence address. Faculty of Medicine, University of Aleppo, Al Jamiliyah, 15310 Aleppo, Syria. Tel: +936937188550; Fax: +936212256271; E-mail: ayaqouli@ 123456gmail.com
              Author information
              http://orcid.org/0000-0002-6306-3354
              Article
              omaa007
              10.1093/omcr/omaa007
              7048075
              67c94a49-4af8-422b-be8d-11ca3119cd1c
              © The Author(s) 2020. Published by Oxford University Press.

              This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

              History
              : 9 September 2019
              : 16 January 2020
              : 22 January 2020
              Page count
              Pages: 3
              Categories
              Case Report

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