A nephrotic syndrome is reported in a 22 year old man. High hemoglobin values and erythrocyte counts were dominant features. Despite very low serum proteins there was no edema. For more than a year the condition was fairly stationary with mild symptoms. During steroid therapy a dramatic change occurred. During the first 11 days the marked proteinuria disappeared and the hemoglobin concentration fell from 21.5 to 18.4 g/l00 ml. Concomitantly, there was a rapid rise in the serum proteins and a fall in the serum cholesterol level. It is suggested that this patient had a normal red cell volume and a markedly reduced plasma volume which was restored during the steroid therapy. This might explain the rapid reduction in the hemoglobin concentration. This view is in accordance with previous investigations which have shown that the nephrotic syndrome may be accompagnied by a very low plasma volume.

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© 1965 S. Karger AG, Basel
1965
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