ABSTRACT
We present three patients, aged 4, 6 and 8 years old, with a diagnosis of urinary tract infection. In all patients, initial ultrasonographic studies revealed a single area of acute lobar nephronia (ALN). The patients underwent renal scintigraphy with dimercaptosuccinic acid-99mTc (DMSA Tc 99m), which showed multiple foci with below normal uptake in both kidneys of two patients, consistent with bilateral multifocal bacterial nephritis. Although this entity has been reported together with ALN in adults, very few pediatric cases have been reported. We emphasize the diagnostic value of ultrasonography and renal scintigraphy.
Subject(s)
Nephritis/diagnosis , Urinary Tract Infections/diagnosis , Acute Disease , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Se presentan 3 pacientes pediátricos de 4, 6 y 8 años de edad con infección del tracto urinario (ITU). Los pacientes fueron estudiados inicialmente mediante ecografía, y en todos ellos se detectó un foco único de nefronía lobar aguda. Tras la realización de una gammagrafía renal con ácido dimercaptosuccínico 99mTc (DMSA), dos de ellos presentaban múltiples focos de hipocaptación en ambos riñones que manifestaban nefritis bacteriana multifocal bilateral. Aunque esta entidad ha sido descrita junto a la nefronía lobar aguda en el adulto, existen muy pocos casos descritos en la literatura pediátrica. Se desea subrayar el valor diagnóstico de la ecografía junto con la gammagrafía renal (AU)
Subject(s)
Child , Child, Preschool , Male , Female , Humans , Urinary Tract Infections , Nephritis , Acute DiseaseABSTRACT
OBJECTIVE: Relationships have been found between obesity and changes in serum lipid levels which may lead to antherogenic lipid profiles. There are few studies treating obesity and showing the possibility of improving lipid abnormalities in prepubertal obese patients. PATIENTS AND METHODS: One hundred and three obese patients ranging from 5.3 to 9.9 years old have been studied. Anthropometric (height, weight, body mass index-BMI-, and subscapular and triceps skinfolds) and lipid (total and lipoprotein cholesterol, triglycerides, apoprotein A1 and B) parameters were measured both at the beginning of the study and after six months of diet treatment. Patients were included in three groups according to their response to treatment: good response (GR), no response (NR) and bad response (BR), if the difference in BMI was less than 1 point (< 1), between -1 and +1 and more than 1 point (> 1), respectively. RESULTS: Forty-one patients (39.8%) were noncompliant. Of the remaining sixty-two, 41 (66%) had a GR, 16 (25.8% NR and 5 (8%) BR. The obese patients showed a significantly lower HDL-C (38.8 +/- 15.6 vs 48.3 +/- 10.2 mg/dl, p < 0.01) in comparison to the control group. GR patients showed a statistically significant increase in HDL-C (48.2 +/- 9.1 vs 54.9 +/- 12.0 mg/dl, p < 0.01) and apoprotein A1 (126.7 +/- 17.3 vs 136.0 +/- 17.4 mg/dl, p < 0.05) levels at the end of the study. There was no statistically significant difference in serum lipid levels in the other two groups. There was no statistically significant correlation between serum lipid levels and anthropometric parameters. The difference between final minus initial value in both lipid and anthropometric parameters were not correlated. Sixteen patients (17.7%) had pathological serum lipid levels, 15 of them showing hypertriglyceridemia, that disappeared in GR patients. CONCLUSIONS: Prepubertal obese patients show alterations in lipid profiles and this is not correlated with anthropometric parameters. The improvement in these anthropometric parameters improve the lipid profile. Initial pathologic serum lipid levels in GR patients become normalized.
