ABSTRACT
Ormond's disease (RPF) is chronic inflammatory process characterized by intensive fibrosis and inflammatory cells infiltration in retroperitoneal space. RPF in most cases possess idiopathic origin and is rare in children. The histopathologic verification is needed for establishing a proper diagnosis of disease. In this study a case of RPF in 17-year-old girl was reported which caused many diagnostical and therapeutical difficulties. In our patient streptococcal tonsillitis was recognized as a primary cause of disease.
Subject(s)
Retroperitoneal Fibrosis/diagnosis , Retroperitoneal Fibrosis/therapy , Adolescent , Female , Humans , Retroperitoneal Fibrosis/microbiology , Retroperitoneal Fibrosis/pathology , Retroperitoneal Space/pathology , Streptococcal Infections/complications , Tonsillitis/complicationsABSTRACT
BACKGROUND: Biochemical and hormonal disturbances in calcium-phosphate storage accompanying chronic renal failure (CRF) lead to the loss of bone mass and the destruction of bone microarchitecture. The aim of this study was to evaluate the serum levels of PICP (procollagen I carboxyterminal propeptide) and ICTP (carboxyterminal telopeptide of type I collagen) as markers of bone growth in CRF children treated conservatively. MATERIAL/METHODS: 34 children (16 female and 18 males) with predialytic CRF, aged 6 to 18 years (average age 11.3+/-3.8 years) were included in the experimental group. The controls were 20 healthy age-matched children. The experimental subjects were divided into two subgroups, based on the blood level of intact PTH (iPTH). Subgroup Ia (n=7) consisted of children with normal serum concentrations of iPTH. Subgroup Ib (n=27) consisted of children with elevated serum concentrations of iPTH. RESULTS: In group Ia characteristic correlations were found between OST (osteocalcin) and ICTP, and between creatinine and ICTP. In group Ib, positive correlations were found between iPTH and PICP, iPTH and ICTP, OST and ICTP, and ICTP and PICP. In this group no correlation was found between marker turnover and creatinine. CONCLUSIONS: The results of our study of PICP and ICTP as markers of bone metabolism in children with CRF in the predialysis period indicate that their levels should be routinely monitored as specific biochemical parameters of bone structure.
Subject(s)
Genetic Markers , Kidney Failure, Chronic/metabolism , Kidney Failure, Chronic/therapy , Peptide Fragments/metabolism , Procollagen/metabolism , Adolescent , Bone and Bones/metabolism , Child , Chronic Kidney Disease-Mineral and Bone Disorder/metabolism , Collagen Type I , Dose-Response Relationship, Drug , Female , Humans , Male , Osteocalcin/metabolism , Parathyroid Hormone/metabolism , PeptidesABSTRACT
UNLABELLED: Bone disorders resulting from abnormalities in mineral are common in patients with predialytic stage of chronic renal failure (CRF). Disturbances associated with: phosphate excretions, vitamin D3 metabolism, hypocalcemia, increased parathyroid hormone (PTH) and acid-base disturbances lead to bone pathology know as renal osteodystrophy (RO). Estimation of tempo turnover make possible markers, of which concentration means oneself in urine and in serum. The aim of this study was to estimate the urinary carboxy-terminal telopeptide of type I collagen as a index of bone resorption and osteocalcin as a marker of bone formation in correlation with intact PTH (iPTH) in predialytic children. The study group consisted of 39 children aged 6-17 y. All children were divided into 2 groups: I--21 predialytic pts; II--18 healthy children. The I group was divided into 2 subgroups: Ia--pts with normal range of iPTH; Ib--pts with higher range of iPTH. All patients were tested: for serum concentrations of: calcium (Ca), inorganic phosphorus (P), iPTH, OST; and for urinary CrossLaps (corrected with urinary creatinine). RESULTS: In subgroup Ib revealed correlation between OST and iPTH (p < 0.05); and between CrossLaps and OST (p = 0.05). CONCLUSIONS: The results of investigation on OST and CrossLaps as bone metabolism markers in predialytic children revealed that evaluating highly specific biochemical parameters of bone turnover is useful in assessing the clinical status of that metabolism. The knowledge of correlation between levels of bone turnover markers and clinical status of a child might help in taking appropriate therapeutic decision and in preventing renal osteodystrophy.
