ABSTRACT
Background@#The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. @*Methods@#This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. @*Results@#Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53%) and infection (44%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. @*Conclusions@#Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.
ABSTRACT
Herein, we report two rare cases of renal infection. The first case was renal subcapsular urine reflux in a 8-month-old girl with recurrent urinary tract infection and the second was subcapsular abscess in a 14-year-old girl with diabetes, who was successfully treated with percutaneous drainage. It has been suggested that renal subcapsular abscesses could be caused by the direct reflux of urine into the subcapsular space, rather than spread of infection from an existing parenchymal lesion, and that complete recovery can be achieved if percutaneous drainage is performed in a timely manner. We propose primary subcapsular reflux, in which urine directly refluxes upwards into the subcapsular space of the kidney, as one of the mechanisms for development of renal subcapsular abscesses.
ABSTRACT
Fluoride is one of the most reactive elements in nature, and commonly used in toothpaste since it helps to prevent cavities. Despite this advantage, excessive ingestion of fluoride can cause acute toxicity and gastric disturbance from hydrofluoric acid that was formed in the stomach. We report a case of previously healthy, 41-month-old girl who visited the emergency department with persistent abdominal pain and hematemesis after ingestion of fluoride-containing toothpaste. Though the ingested dose of fluoride was below the toxic dose, serious symptoms developed. We performed esophagogastroduodenoscopy, and confirmed a hemorrhagic gastritis caused by hydrofluoric acid. The girl was uneventfully discharged on day 3 after receiving conservative care. When managing children who ingested fluoride-containing toothpaste, physicians need to consider their symptoms, not the ingested amount. In addition, parents should be cautious when their children use fluoride-containing toothpaste.
ABSTRACT
Fluoride is one of the most reactive elements in nature, and commonly used in toothpaste since it helps to prevent cavities. Despite this advantage, excessive ingestion of fluoride can cause acute toxicity and gastric disturbance from hydrofluoric acid that was formed in the stomach. We report a case of previously healthy, 41-month-old girl who visited the emergency department with persistent abdominal pain and hematemesis after ingestion of fluoride-containing toothpaste. Though the ingested dose of fluoride was below the toxic dose, serious symptoms developed. We performed esophagogastroduodenoscopy, and confirmed a hemorrhagic gastritis caused by hydrofluoric acid. The girl was uneventfully discharged on day 3 after receiving conservative care. When managing children who ingested fluoride-containing toothpaste, physicians need to consider their symptoms, not the ingested amount. In addition, parents should be cautious when their children use fluoride-containing toothpaste.