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日本轮状病毒性胃肠炎相关梗阻性尿路病的临床特征

Clinical characteristics of obstructive uropathy associated with rotavirus gastroenteritis in Japan.

作者信息

Ashida Akira, Fujieda Mikiya, Ohta Kazuhide, Nakakura Hyogo, Matsumura Hideki, Morita Taku, Igarashi Takashi, Tamai Hiroshi

机构信息

Department of Pediatrics, Osaka Medical College, Osaka, Japan.

出版信息

Clin Nephrol. 2012 Jan;77(1):49-54. doi: 10.5414/cn107098.

Abstract

AIMS

Rotavirus gastroenteritis is severe and often results in dehydration and pre-renal azotemia. However, we have encountered four children with acute obstructive uropathy associated with acute rotavirus gastroenteritis, and several similar cases have been reported. Therefore, the aim of the present study was to clarify the epidemiology and clinical features of acute obstructive uropathy associated with acute rotavirus gastroenteritis in Japanese children.

PATIENTS AND METHODS

We sent questionnaires to all members of the Japanese Society for Nephrology and all authors who had published case reports of this disease in Japan, inquiring about patient age at diagnosis, sex, the type of stones, laboratory data and other factors.

RESULTS

21 reported patients were evaluable, ranging from 0.4 to 3 years. The sex distribution showed a strong male prevalence. Oliguria had appeared about 7 days after the onset of gastroenteritis. Most of the patients showed hyperuricemia and hyponatremia. The stones consisted mainly of ammonium acid urate. The patients were discharged with normal renal function.

CONCLUSION

Although obstructive uropathy associated with rotavirus gastroenteritis is very rare, this disease condition should be explored when anuria is refractory to sufficient fluid replacement therapy or when oliguria persists despite recovery of the gastrointestinal symptoms.

摘要

目的

轮状病毒性胃肠炎病情严重,常导致脱水和肾前性氮质血症。然而,我们遇到了4例与急性轮状病毒性胃肠炎相关的急性梗阻性尿路病患儿,并且已有数例类似病例的报道。因此,本研究的目的是阐明日本儿童中与急性轮状病毒性胃肠炎相关的急性梗阻性尿路病的流行病学和临床特征。

患者与方法

我们向日本肾脏病学会的所有成员以及在日本发表过本病病例报告的所有作者发送了调查问卷,询问诊断时的患者年龄、性别、结石类型、实验室数据及其他因素。

结果

21例报告患者可供评估,年龄从0.4岁至3岁。性别分布显示男性明显居多。少尿出现在胃肠炎发病后约7天。大多数患者表现为高尿酸血症和低钠血症。结石主要由尿酸铵组成。患者出院时肾功能正常。

结论

虽然与轮状病毒性胃肠炎相关的梗阻性尿路病非常罕见,但当充分补液治疗后无尿仍难以纠正或胃肠道症状恢复后少尿持续存在时,应排查这种疾病情况。

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