Does Nephrotic syndrome without proteinuria exist?

Abstract

A four-year-old boy visited our clinic with abdominal distension, pretibial pitting edema, hypoalbuminemia without any abnormal findings in urinalysis. One week prior to the onset, he had an episode of Influenza B infection treated with Oseltamivir phosphate. As the hypoalbuminemia improved without treatment, we could not specify the pathogenesis of his symptom. However, he returned to our clinic with typical Nephrotic syndrome with proteinuria one and a half months later. A conventional steroid therapy for Nephrotic syndrome succeeded in prompt improvement such as edema and proteinuria. He has not experienced a relapse so far. Because the clinical course and the laboratory findings of both episodes resembled to each other except for proteinuria, we speculate that the first episode may have represented the convalescent process of Nephrotic syndrome.