Martin Marlene, Rodriguez Kristina, Sánchez-Sauco Miguel, Zambudio-Carmona Gerardo, Ortega-García Juan Antonio
J Med Case Rep. 2009 Mar 30;3:6626. doi: 10.1186/1752-1947-3-6626.
Bladder exstrophy is a rare urogenital abnormality. Other urogenital malformations have been associated with exposure to hormonal pesticide disruptors during critical developmental periods. This is the first report in the literature to associate household exposure to pesticides with bladder exstrophy.
We describe the pediatric environmental history of a newborn baby boy with isolated bladder exstrophy. In this case the pediatric environmental history includes the constitutional, genealogical, genetic and environmental factors related to bladder exstrophy, which revealed a cockroach infestation in the parents' home and the daily use of bug spray to kill them. The mother used one bottle of spray every 2 days (1000cc) and more in the summer, when the problem was worse. During gestational weeks 0-12, the mother intensively used a domestic pesticide consisting of a mixture of pyrethroids (cyfenothrin 0.5%, and tetramethrin 0.31%) and pyriproxyfen (0.01%). She described repeated episodes of mild to moderate poisoning that are associated with the use of household pesticides. The mother is a housewife and the father works as a fumigator of fruit fields and he reported gastrointestinal symptoms associated with the use of occupational pesticides. However, he did not believe he carried traces of these products into the home and his wife washed his work clothes separately. The pyrethroids and pyriproxyfen were detected in a urine sample obtained from the child 4 months after he was born. No other risk factors were identified.
A detailed and carefully conducted pediatric environmental history, which includes information about home pesticide use, should be carried out for all children with bladder exstrophy. Domestic exposure to pesticides during critical developmental periods may have deleterious effects for the fetus.
膀胱外翻是一种罕见的泌尿生殖系统异常。其他泌尿生殖系统畸形与在关键发育时期接触激素性农药干扰物有关。这是文献中首次报道家庭接触农药与膀胱外翻之间的关联。
我们描述了一名患有孤立性膀胱外翻的男婴的儿科环境史。在这个病例中，儿科环境史包括与膀胱外翻相关的体质、家族、遗传和环境因素，结果发现患儿父母家中有蟑螂出没，且每天使用杀虫剂来消灭它们。母亲每两天使用一瓶喷雾剂（1000 毫升），在问题更严重的夏季使用量更多。在妊娠第 0 - 12 周期间，母亲大量使用了一种家用农药，该农药由拟除虫菊酯（氯氰菊酯 0.5%和胺菊酯 0.31%）和吡丙醚（0.01%）的混合物组成。她描述了与使用家用农药相关的多次轻度至中度中毒发作。母亲是家庭主妇，父亲是果园熏蒸工，他报告了与使用职业性农药相关的胃肠道症状。然而，他不认为自己将这些产品的痕迹带回了家中，而且他的妻子会单独清洗他的工作服。在患儿出生 4 个月后采集的尿液样本中检测到了拟除虫菊酯和吡丙醚。未发现其他风险因素。
对于所有患有膀胱外翻的儿童，都应进行详细且精心的儿科环境史调查，其中应包括家庭农药使用情况的信息。在关键发育时期家庭接触农药可能对胎儿产生有害影响。
