We present the case of an adolescent girl with prominent clitoral swelling as the first symptom when she presented to the emergency department, and who was subsequently diagnosed with nephrotic syndrome.
A 14-year-old adolescent girl was admitted with painless clitoral swelling. She denied recent masturbation, itching, or discharge. She was within the last few days of menstruation. Physical examination revealed clitoral edema without erythema or genital edema. Urine dipstick test and microscopic evaluation revealed protein 2+, blood 3+, abundant erythrocytes and 9–10 leukocytes. A few days later, additional clinical findings, such as pretibial and facial edema, were diagnosed as nephrotic syndrome.
Summary and Conclusion
This case is a reminder that clitoral swelling is to be considered a sign in the diagnosis of nephrotic syndrome, even when it occurs alone.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Pediatric and Adolescent Gynecology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Does urinary tract infection cause proteinuria or microalbuminuria? A systematic review.Nephrol Dial Transplant. 2006; 21: 3031
- Hair thread tourniquet syndrome in adolescents: a presentation and review of the literature.J Pediatr Adolesc Gynecol. 2005; 18: 155
- Lesions of clitoris: a review.J Low Genit Tract Dis. 2015; 19: 68
- A case of unusual clitoromegaly.J Pediatr Adolesc Gynecol. 2018; 31: 543
- Nephrotic syndrome in infants and children: pathophysiology and management.Paediatr Int Child Health. 2017; 15: 1
- Perspectives on edema in childhood nephrotic syndrome.Am J Physiol Renal Physiol. 2015; 309: 575
Published online: February 08, 2019
The authors indicate no conflicts of interest.
Written permission was obtained from the patient and her family for publication of this report.
© 2019 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.