The practice of pediatrics . s an acute exudative and an acute productivenephritis Symptomatology.—The onset of primary nephritis is often abrupt,the disease beginning with fever, headache, vomiting, restlessness,muscular twitchings, and, rarely, convulsions. While not usually anearly symptom, dropsy occasionally first directs the attention of the DISEASES OF THE KIDNEYS 783 physician to the kidneys. In many cases the beginning is insidious,without marked renal symptoms, and will be detected only by thephysician who always examines the urine of sick children. The temper-ature is irregular in t
The practice of pediatrics . s an acute exudative and an acute productivenephritis Symptomatology.—The onset of primary nephritis is often abrupt,the disease beginning with fever, headache, vomiting, restlessness,muscular twitchings, and, rarely, convulsions. While not usually anearly symptom, dropsy occasionally first directs the attention of the DISEASES OF THE KIDNEYS 783 physician to the kidneys. In many cases the beginning is insidious,without marked renal symptoms, and will be detected only by thephysician who always examines the urine of sick children. The temper-ature is irregular in type and not, as a rule, high. Fever may be absentduring the first few days. In infants, however, a high temperatureis often seen. Diarrhea has been noted in quite a number of cases. In addition to the nervous symptoms above noted, severe cases withuremia show dulness and apathy, sometimes approaching coma. Holtstates that anemia was a prominent symptom in his cases, and in severalinstances suggested the diagnosis. Fig. 163. Urinary sediment in acute nephritis; hyaline, granular, and epithelial casts. The urine may not be greatly decreased in amount, particularly inthe beginning of the disease. Later it is often scant, and not infrequentlysuppressed. This symptom varies greatly in different cases and atdifferent times in the course of an individual case. It is high coloredand turbid, often red or smoky from the presence of blood. The specificgravity is high with scanty and low with abundant urine. Albumin isalways present and in varying amounts, even enough to coagulate solid 784 DISEASES OF THE GENITOURINARY SYSTEM on boiling. The amount may vary greatly from day to day, regardless ofother symptoms. Casts—hyaline, granular, epithelial—are always present, usuallytogether with epithelial cells, debris, leukocytes,and blood cells (Fig. ]H3).In some cases there may be only an occasional granular or hyalinecast, and in others many of all varieties. Dropsy may be slight ormarke
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectchildren, bookyear190
