ABSTRACT
Xanthogranulomatous pyelonephritis in childhood is a rare chronic pyelonephritis often assodiated with calculi of urinary tract obstruction, with a clinical presentation of renal mass. A 3-year old boy was admitted to Korea University Hospital complaining of intermittent fever and palpable mass at right upper quadrant of the abdomen. The CBC revealed increased ESR and the finding of iron deficientcy anemia. Proteus mirabilis was cultured from the urine. We found the idiopathic hypercalciuria was affected also. Intravenous pyelogram. ultrasonogram and abdominal computerized tomogrhapy demonstrated a multiple cystic lesion with renal calculi at upper and lower pole of right kidney. Right nephrectomy was performed under the suspicion of the renal abscess with renal stone. Postoperatively microscopic examination revealed parenchymal destruction with infiltration of foamy phagocytes, giant cells, and plasma cells. In conclusion, we experienced a case of xanthogranulomatous pyelonephritis with idiopathic hypercalciuria in a child. So, we report it with a review of literature.
Subject(s)
Child , Child, Preschool , Humans , Male , Abdomen , Abscess , Anemia , Calculi , Fever , Giant Cells , Hypercalciuria , Iron , Kidney , Kidney Calculi , Korea , Nephrectomy , Phagocytes , Plasma Cells , Proteus mirabilis , Pyelonephritis , Pyelonephritis, Xanthogranulomatous , Ultrasonography , Urinary TractABSTRACT
Lipoprotein(a) [Lp(a)] is considered an additional, independent and largely genetically determined risk factor for the development of premature coronary heart disease. Furthermore abnormal plasma lipoprotein patterns have been associated with increased risk for developing coronary heart disease. Among these lipoproteins, an increased concentration of serum Apo B and decreased level of Apo A are considered as major risk factors. together with elevated serum cholesterol and decreased HDL cholesterol. The aim of this study is to assess serum Lp(a) levels in newborns and to observe their evolution between brith, 7 days and 1 month in 64 healthy newborns by using ELISA method, Other lipid profiles were also measured and compared with feeding formula methods. The results obtained were as follows: 1) There were no significant changes from birth to 7 days, but was increased significantly after 7 days to 1 month of serum Lp(a) concentrations. 2) There were dramatic increases between birth and 7 days for Apo B and did not change between 7 days and 1 month, while Apo A-I was already present in significant levels at birth and was changed continuously between 7 days and 1 month. 3) There were marked increases between birth and 7 days for total cholesterol and triglycerides, while after 7 days the cholesterol levels only progressively increased until month. 4) There were continuous increases between birth and 7 days and 1 month for HDL-C, while LDL-C was markedly increased between birth and 7 days. 5) There were no significant correlations between serum Lp(a)concentrations and other lipid profiles neither age, sex and feeding formulas. In conclusion, our data suggest that the adequate timing for the screening test of Lp(a) in newborns is around 1 month after birth and there are no statistically significant correlations between Lp(a) and other lipid profiles.
Subject(s)
Humans , Infant, Newborn , Apolipoprotein A-I , Apolipoproteins B , Cholesterol , Cholesterol, HDL , Coronary Disease , Enzyme-Linked Immunosorbent Assay , Lipoprotein(a) , Lipoproteins , Mass Screening , Parturition , Plasma , Risk Factors , TriglyceridesABSTRACT
The frequent occurrence of hematuria in children necessitates diagnostic evaluation. Hematuria may occur with either renal or lower urinary tract disease. Clarification of the etiology of hematuria, whether microscopic or gross, is facilited by localizing the site of bleeding to the kidney (glomerular) or the lower urinary tract (non-glomerular). The mean cellular volume (MCV) of urinary red blood cells (RBCs) of pediatric patients with glomerular (group I; n=77) and non-glomerular (group II; n=34) hematuria was determined using Coulter Counter Model S plus IV. We found that re blood cells of glomerular origin had a smaller volume than non-glomerular cells(73.79 9.75 m3 vs 83.55 3.77 m3, p<0.001). If an urinary MCV equal to 80.56 m3 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 89 (80%) of the 111 patients studied (sensitivity 76%, specificity 88%). The ratio of the urinary erythrocyte MCV to that in blood(Umcv/Bmcv) was compared with the diagnosis. If an Umcv/Bmcv ratio equal to 0.95 was taken as the cut-off value between glomerular and non-glomerular hematuria, a correct assessment of the site of bleeding was made in 93 (83%) of the 111 patients studied (sensitivity 79.6%, specificity 94%). Coulter counter analysis of urine provides a simple noninvasive and objective aid to the diagnosis of hematurai. This test, when used early in the management of pediatric patients with hematuria, may help to avoid invasive investigations.
Subject(s)
Child , Humans , Blood Cells , Diagnosis , Erythrocytes , Hematuria , Hemorrhage , Kidney , Sensitivity and Specificity , Urinary Tract , Urologic DiseasesABSTRACT
No abstract available.