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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Zhuang, Xiao-Hui Mo, Ying Jiang, Xiao-Yun Chen, Shu-Mei |
| Description | Country affiliation: China Author Affiliation: Zhuang XH ( Department of Pediatrics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.) |
| Abstract | BACKGROUND: Since the diverse manifestations of renal impairment appear in different periods of Wilson's disease, misdiagnosis or missed diagnosis is not rare. This study was undertaken to find the clinical features of renal impairment in children with Wilson's disease or hepatolenticular degeneration (HLD). METHODS: Eighty-five children with HLD who had been treated at our department between January 1991 and June 2006 were retrospectively studied. The clinical data of 25 patients with renal impairment were analyzed. RESULTS: In the 85 HLD patients, 34 had renal impairment. Nine of the 34 patients with D-penicillamine treatment were excluded. In the remaining 25 patients, 7 had initiated symptoms of renal impairment, 5 of them with edema, 1 with gross hematuria, and 1 with acute hemolysis and acute renal failure. Twelve of the 25 patients had proteinuria, 14 had hematuria, and 5 had both proteinuria and hematuria. Urine glucose was positive in 4 patients, urine N-acetyl-beta-D-glucosaminidase (NAG) increased in 5, and urine beta2-microglobulin increased in 6. Urine red blood cell (RBC) phase was detected in 7 patients, including glomerular hematuria in 5 patients and non-glomerular hematuria in 2. Blood urea nitrogen and creatinine increased in 1 patient. B-ultrasound revealed bilaterally enlarged kidneys in 3 patients. Kidney biopsy showed diffuse mesangial proliferation and IgA deposit in mesangial region in 1 patient. All of the 25 patients had cornea K-F ring and the level of ceruloplasmin decreased. Six patients had a family history of HLD. CONCLUSIONS: The manifestations of renal impairment with HLD are varied. HLD should be excluded from patients with unexplained renal impairment, while those with HLD should take examinations of the kidney to identify renal impairment. We propose that renal function and urinalysis should be checked regularly in patients receiving treatment of D-penicillamine. |
| File Format | HTM / HTML |
| ISSN | 17088569 |
| Issue Number | 2 |
| Volume Number | 4 |
| e-ISSN | 18670687 |
| Journal | World Journal of Pediatrics |
| Language | English |
| Publisher | Springer |
| Publisher Date | 2008-05-01 |
| Publisher Place | Switzerland |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pediatrics Hepatolenticular Degeneration Complications Physiopathology Renal Insufficiency Diagnosis Acetylglucosaminidase Urine Acidosis, Renal Tubular Etiology Adolescent Ceruloplasmin Metabolism Chelating Agents Therapeutic Use Child Female Glycosuria Hematuria Drug Therapy Humans Kidney Function Tests Male Penicillamine Proteinuria Retrospective Studies Urinalysis Case Reports Journal Article |
| Content Type | Text |
| Resource Type | Case study Article |
| Subject | Pediatrics, Perinatology and Child Health |
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