Bilge I, Kayserili H, Emre S, Nayir A, Sirin A, Tukel T, Bas F, Kilic G, Basaran S, Gunoz H, Apak M
Pediatr Nephrol. 2000 Oct;14(12):1111-4. doi: 10.1007/s004670000315.
We evaluated the frequency of renal malformations in relation to nonmosaic 45,X (group A, 45 patients, 54.9%) and mosaic/structural abnormalities of X (group B, 37 patients, 45.1%) in 82 Turkish patients with Turner syndrome (TS). Ultrasonography of the kidneys and collecting system was performed in all patients. Of the 82 patients, 31 had different renal malformations (37.8%). Horse-shoe kidney was observed in 9 (29.0%) of the 31 patients, and 17 patients (54.8%) had various collecting system malformations, while 5 (16.2%) had malrotation and other positional abnormalities. The prevalence of renal malformations was significantly higher in group A (51.1%) than group B (21.6%) (2:7.94, P<0.05). Although 8 of the 9 patients with horse-shoe kidney had the 45,X karyotype, collecting system malformations were observed more frequently in group B. Recurrent urinary tract infections (UTIs) were detected during follow-up in 7 patients, and hypertension developed in 3 patients. In patients who had a normal baseline nephrological evaluation, no problem suggesting renal disease developed during follow-up. We conclude that all forms of TS should have routine nephrological screening on diagnosis, since structural malformations of the kidney occur more frequently in nonmosaic 45,X TS, while collecting system malformations are mostly seen in mosaic/structural X forms. Those included in the group for nephrological follow-up had an increased risk for hypertension and/or UTI.
我们评估了82例土耳其特纳综合征(TS)患者中,与非嵌合型45,X(A组,45例,54.9%)及X染色体的嵌合/结构异常(B组,37例,45.1%)相关的肾脏畸形发生率。对所有患者的肾脏及集合系统进行了超声检查。82例患者中,31例有不同的肾脏畸形(37.8%)。31例患者中有9例(29.0%)观察到马蹄肾,17例患者(54.8%)有各种集合系统畸形,而5例(16.2%)有旋转不良及其他位置异常。A组肾脏畸形的发生率(51.1%)显著高于B组(21.6%)(比值比:7.94,P<0.05)。虽然9例马蹄肾患者中有8例为45,X核型,但集合系统畸形在B组中更常见。随访期间7例患者检测到复发性尿路感染(UTI),3例患者出现高血压。在基线肾脏评估正常的患者中,随访期间未出现提示肾脏疾病的问题。我们得出结论,所有类型的TS在诊断时均应进行常规肾脏筛查,因为非嵌合型45,X TS中肾脏结构畸形更常见,而集合系统畸形多见于嵌合/结构X型。纳入肾脏随访组的患者发生高血压和/或UTI的风险增加。