Filariasis causing nephrotic syndrome is rare and reported only in adults but not in pediatric age group(1). We report here an interesting case of a girl with nephrotic syndrome secondary to filariasis. A ten-year-old girl was admitted with generalized body swelling and decreased urine output for one month. There was no history of hematuria or dysuria. On examination she had anasarca and her blood pressure was normal. She had a distended abdomen due to ascites and grossly edematous lower limbs. Investigations revealed the following: Hb 12 g%, TC 5000/cu mm, DC - N 62% E 12% L 26%. Serum analysis showed Urea 32 mg/dL, total protein 3.9 g/dL, albumin 1.1 mg/dL, and cholesterol 498 mg/dL. Urine examination revealed massive proteinuria, normal microscopy and absence of chyluria. In view of eosinophilia and longstanding pedal edema, filariasis was considered. Peripheral smear was positive for microfilaria and filarial serology was also strongly positive by indirect hemagglutination. She was treated with diethylcarbamazine for 3 weeks and she went into remission after 10 days.

In this child with filariasis, all the criteria for nephrotic syndrome namely edema, proteinuria, hypoalbuminemia and hyperlipidemia were present. A remission induced by antifilarial therapy also supports the filarial etiology for nephrotic syndrome. Nephritis due to microfilaria has been postulated as a possible mechanism for the development of nephrotic syndrome(2). Chyluria due to Bancroftian filariasis leading to hypoalbuminemia is documented in literature(3). The absence of chyluria in this girl rules out hypoalbuminemia due to filariasis per se. However, microfilaria could not be documented by renal biopsy. Hence, filariasis is the probable cause for nephrotic syndrome in this girl.

1. Yap HK, Woo KT, Yeo PP, Chiang GS, Singh M, Lim CH. The nephrotic syndrome associated with filariasis. Ann Acad Med Singapore 1982; 11: 60-63.

2. Rao RV, Anupindi L, Chatterjee A, Varghese GK, Krishnanand BR. Filarial nephritis: A cause of nephrotic syndrome. Trop Geogr Med 1993; 45: 180-181.

3. Suzuki R, Morita H, Sugenoya Y, Mizobuchi M, Yamamoto W, Ideura T, Yoshimura A. A case report of chronic chyluria probably due to Bancroftian filariasis, which showed hypoproteinemia. Nippon Jinzo Gakkai Shi 2001; 43: 63-68.