What should be suspected in a patient with nephrotic syndrome (a collection of symptoms indicating kidney damage, including severe swelling, particularly in your legs and feet, due to kidney excretion of large amounts of protein in the urine) who now presents with fever (elevated body temperature)?

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Last updated: February 9, 2025View editorial policy

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Differential Diagnosis for Nephrotic Syndrome with Fever

Single Most Likely Diagnosis

  • Infection: Patients with nephrotic syndrome are at increased risk of infections due to the loss of immunoglobulins in the urine, making infection the most likely cause of fever in this context. Common infections include pneumonia, urinary tract infections, and cellulitis.

Other Likely Diagnoses

  • Thromboembolic Events: Nephrotic syndrome increases the risk of thromboembolic events due to the loss of anticoagulant proteins in the urine. Fever can be a presenting symptom of a thromboembolic event, such as pulmonary embolism or deep vein thrombosis.
  • Medication Side Effects: Certain medications used to treat nephrotic syndrome, such as corticosteroids and immunosuppressants, can cause fever as a side effect.

Do Not Miss Diagnoses

  • Sepsis: Although less common, sepsis is a life-threatening condition that requires prompt recognition and treatment. Patients with nephrotic syndrome are at increased risk of sepsis due to their immunocompromised state.
  • Post-Streptococcal Glomerulonephritis (PSGN): PSGN is a complication of streptococcal infection that can cause nephrotic syndrome. Fever can be a presenting symptom of PSGN.

Rare Diagnoses

  • Vasculitis: Certain types of vasculitis, such as ANCA-associated vasculitis, can cause nephrotic syndrome and fever.
  • Lupus Nephritis: Systemic lupus erythematosus (SLE) can cause nephrotic syndrome and fever, although this is a less common cause of nephrotic syndrome.
  • Amyloidosis: Amyloidosis is a rare condition that can cause nephrotic syndrome and fever, although this is typically seen in the context of chronic disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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