Symptoms & Signs

Common symptoms of nephritic syndrome are:

* Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas* Blood in the urine (urine appears dark, tea colored, or cloudy)* Decreased urine volume (little or no urine may be produced)

Other symptoms that may occur include:

* Blurred vision* General aches and pains (joint pain, muscle aches)* General ill feeling (malaise)* Headache* Slow, sluggish, lethargic movement* Cough containing mucus or pink, frothy material* Decreased alertness, drowsiness, confusion

Patients may develop symptoms of acute kidney failure or end-stage kidney disease.

Diagnosis & Tests

During an examination, your health care provider may find the following signs:

* High blood pressure* Signs of fluid overload (when examining the abdomen)* Enlarged liver* Abnormal heart and lung sounds* Enlarged neck veins from increased pressure* General swelling* Signs of acute kidney failure

Tests that may be done include:

* BUN* Creatinine* Creatinine clearance* Urinalysis* Urine appearance and color* Potassium test* Protein in the urine

A kidney biopsy will reveal inflammation of the glomeruli, which may indicate the cause.

Tests to determine the cause of acute nephritic syndrome may include:

* ANA titer (lupus)* ANCA (antineutrophil cytoplasmic antibody for vasculitis)* Anti-glomerular basement membrane antibody* Blood culture* Culture of the throat or skin* Serum complement (C3 and C4)

Review Date : 8/12/2009Reviewed by : Parul Patel, MD, Private practice specializing in Nephrology and Kidney and Pancreas Transplantation, California Pacific Medical Center, San Francisco, CA. Review provided by VeriMed Healthcare Network. also reviewed by David Zieve, MD, MHA, Medical Director, a.D.a.M., inc.The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. a licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. © 1997- 2010 a.D.a.M., inc. any duplication or distribution of the information contained herein is strictly prohibited. Tags: Acute pancreatitis Diagnosis, Acute pancreatitis Diagnosis & Tests, Acute pancreatitis Signs, Acute pancreatitis Symptoms.

An Ontario man with multiple sclerosis died of complications after a controversial treatment in Costa Rica to open up his neck veins, CBC News has learned.

Mahir Mostic, 35, of St. Catharines died on Oct. 19, one day after doctors in the Central American country tried to dissolve a blood-clot complication.

“We didn’t find exactly what happened with Mahir, but I mean it was very terrible story for us,” vascular surgeon Dr. Marcial Fallas of Clinica Biblica in San Jose said Thursday.

“He was a person that was looking [for] some way to improve his life. He found that for a short period of time his life improved.”

After Mostic paid $30,000 US to go to Costa Rica for treatment in late June, he was operated on three times to have a mesh stent inserted to prop open a vein in his neck.

“He started feeling better and got his energy back,” his girlfriend, Bedrana Jelin, said from Visoko, Bosnia-Herzegovina.Mahir Mostic’s MS symptoms improved after his neck veins were opened, but then worsened with fatal blood clot complications, his doctor in Costa Rica said. (Bedrana Jelin)

But his MS symptoms started getting worse and a blood clot formed around the stent in the vein, Fallas said. An ultrasound showed that the vein was 80 per cent blocked.

Mostic was disappointed and desperate. His friends and loved ones raised another $8,000 US to send him back to Costa Rica after they had trouble getting a specialist to see him in Canada.

“They didn’t want to touch him because he was done outside of Canada,” Jelin said.

Mostic flew back to Costa Rica for treatment, but died in hospital there after doctors tried to dissolve the clot using powerful medication that Fallas thinks triggered internal bleeding.

Fallas said his clinic normally doesn’t use stents because they are considered risky. but he said Mostic was willing to take the risk.

Unable to walk

Mostic had been diagnosed with a fast-moving type of multiple sclerosis three years ago. When he first sought the vein-opening procedure, he hadn’t walked for 18 months.

Angioplasty, inflating small balloons to open up arteries, is commonly done for heart patients but is not an approved procedure for unblocking neck veins in MS patients in Canada.

A blood clot in the vein might be more dangerous to fix than to leave alone, said Dr. Barry Rubin, the head of vascular surgery at Toronto’s University Health Network.

“Since veins have a remarkable ability to grow in other locations if one of the veins is blocked, generally it’s extremely safe to just put the patient on blood thinners to try and prevent the clot from extending or breaking off into the lungs, and just waiting,” said Rubin, who is also a professor of surgery at the University of Toronto.

Dr. Marcial Fallas treated Canadian Mahir Mostic in Costa Rica. (Passport Medical)

“You don’t have to go in and dissolve the clot once it’s formed, if it’s in a vein.”

Rubin said Mostic isn’t the first case of a serious complication in an MS patient who has sought treatment outside Canada. Last week, he treated a woman who had the vein procedure in Mexico.

“We found extensive clotting in the left arm reaching into the chest veins, and some of the clots had broken off and travelled to her lungs, which is called a pulmonary embolus, which is life threatening, potentially life-threatening complication.”

Dr. Paulo Zamboni of Italy is a leading proponent of treating multiple sclerosis with angioplasty. His therapy is based on an unproven theory, known as chronic cerebrospinal venous insufficiency (CCSVI), that blocked veins in the neck or spine contribute to MS.

In April, Zamboni warned patients attending the American Academy of Neurology’s annual meeting in Toronto against using stents — small mesh coils — because of the high risk of the stents moving and lack of knowledge about their long-term effects.

In Canada and the U.S., seven research studies are underway to test for vein narrowing in people with MS compared with people without MS.

“Something has to be done because other people are suffering,” Jelin said. “And something has to be done because it’s not fair I lost someone very close to me.”