ABSTRACT
PURPOSE: To determine the diagnostic accuracy of anteroposterior renal pelvic diameter (APD) measurement and the society for fetal urology (SFU) grading in neonatal ultrasonography (USG) for detecting uropathy in newborns having antenatal isolated hydronephrosis (IH), characterized by hydronephrosis without ureter and bladder abnormalities, and to study time to resolution and factors predicting resolution of insignificant hydronephrosis. METHODS: Ninety-six healthy newborns (129 kidneys) with IH, who underwent USG at age 7-30 days and voiding cystourethrography (VCUG) in conjunction with diuretic renography (DR) if APD > 10 mm or SFU grade 3-4 in neonatal USG, and at least a 12-month follow-up were divided into significant and insignificant hydronephrosis using the combined data of sequential USG, VCUG, and DR as the reference standard. RESULTS: Areas under the receiver operating characteristic plots (95 % CI) were 0.86 (0.79-0.94) versus 0.81 (0.73-0.89); p = 0.08, and 87.6 versus 79.8 % of cases were correctly classified, for APD ≥ 16 mm versus SFU grade 4, respectively. Ureteropelvic junction obstruction (UPJO) was the most common uropathy diagnosed. Of 85 kidneys with insignificant hydronephrosis, 57 underwent spontaneous resolution. The resolution rates were 24, 40, and 68 % at age 6, 12, and 24 months, respectively. APD was the only independent factor predicting resolution with the hazard ratio of 0.83 (95 % CI 0.74-0.92; p = 0.001). CONCLUSIONS: In IH, neonatal USG was a useful diagnostic tool to detect uropathy, mainly UPJO. Further investigation should be recommended when APD ≥ 16 mm or SFU grade 4.
Subject(s)
Hydronephrosis/diagnostic imaging , Kidney/diagnostic imaging , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Infant, Newborn , Kidney Pelvis/diagnostic imaging , Male , Reproducibility of Results , Retrospective Studies , Time Factors , Ultrasonography , Ureter/abnormalities , Urinary Bladder/abnormalitiesABSTRACT
Major complications of a percutaneous kidney biopsy are infrequent but warrant early detection and appropriate treatment. We herein report a patient who developed urinoma following kidney biopsy in the effort to emphasize the paramount importance for practitioners to recognize this complication. Prompt diagnosis and proper management of urinoma following kidney biopsy is prudent as delayed treatment may lead to abscess formation, hydronephrosis, obstructive uropathy and chronic kidney failure.
Subject(s)
Biopsy/adverse effects , Kidney/pathology , Urinoma/etiology , Abdominal Pain , Biopsy, Needle , Child , Female , Humans , Hydronephrosis/surgery , Kidney/diagnostic imaging , Kidney Failure, Chronic/surgery , Kidney Function Tests , Tomography, X-Ray Computed , Ultrasonography , Urologic Diseases/surgeryABSTRACT
We report on three patients who developed four episodes of acute pancreatitis while their systemic lupus erythematosus was active and being treated with prednisolone. In all three, gastritis was first considered and treated due to abdominal pain, vomiting, and epigastric tenderness, but their symptoms did not improve. Then pancreatic enzymes were measured, which confirmed pancreatitis. Imaging studies showed an enlarged pancreas in one case, a normal pancreas in two cases, and a focal hypodense nonenhancing parenchyma in one case. Corticosteroids were prescribed for both active SLE and SLE-related pancreatitis. Pulse methylprednisolone was prescribed in one episode, increasing oral prednisolone in one episode, and the same dose of prednisolone continued in the other two episodes. All cases recovered without complications. SLE-related pancreatitis should be considered in SLE patients when the SLE is active and a patient develops abdominal pain and vomiting.
