Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Talas Street, 38039, Kayseri, Turkey,
World J Urol. 2013 Oct;31(5):1117-22. doi: 10.1007/s00345-012-0828-y. Epub 2012 Jan 19.
Urolithiasis in infants is not a very rare situation in Turkey, and the incidence has been increasing in recent years. The purpose of this paper was to investigate the clinical characteristics, metabolic and anatomic risk factors for urolithiasis and microlithiasis in infants.
The cases of 178 infants (63 girls, 115 boys), who were referred to our department between 1999 and 2009 with urolithiasis, were evaluated.
The mean age at diagnosis of stone disease was 11.5 months (range, 10 days-24 months). The mean follow-up duration was 33.6 months (1.2-110 months). The major clinical symptoms of our patients were restlessness in 24 children (13.5%) and vomiting in 23 (13%). Thirty-five infants (19.7%) had a urinary tract abnormality; vesico-ureteral reflux was the most common abnormality (12.9%). Hypercalciuria and hyperuricosuria were detected in 46 and 56%, respectively. Stone analysis was performed in 56 infants, and calcium oxalate was determined in 36 patients (64.3%). A family history of urolithiasis, presenting symptoms and underlying metabolic abnormalities were similar for patients with microlithiasis and those with larger stones. However, infants with microlithiasis had higher ratios for history of vitamin D administration and feeding with formula. Surgical treatment was performed in 42 infants and extracorporeal shock wave lithotripsy in 30 infants.
Our results showed that urolithiasis in infants may present nonspecific symptoms and may even be asymptomatic and that a positive family history for urolithiasis, urologic abnormalities, metabolic disorders, urinary tract infections, vitamin D administration and feeding with formula may increase the occurrence of urolithiasis in infants.
在土耳其，婴儿尿路结石并不罕见，而且近年来发病率呈上升趋势。本文旨在探讨婴儿尿路结石和微结石的临床特征、代谢和解剖学危险因素。
对 1999 年至 2009 年间因尿路结石就诊于我院的 178 例婴儿（63 例女性，115 例男性）进行评估。
结石病的平均诊断年龄为 11.5 个月（范围：10 天-24 个月）。平均随访时间为 33.6 个月（1.2-110 个月）。我们的患者主要临床表现为 24 例（13.5%）患儿烦躁不安和 23 例（13%）患儿呕吐。35 例婴儿（19.7%）存在尿路异常；最常见的异常是膀胱输尿管反流（12.9%）。分别检测到 46%和 56%的患儿存在高钙尿症和高尿酸尿症。56 例患儿进行了结石分析，其中 36 例（64.3%）患儿检测到草酸钙。微结石组和大结石组患儿的家族尿路结石史、症状表现和潜在代谢异常相似。然而，微结石患儿有更高的维生素 D 治疗史和配方奶喂养史。42 例患儿接受了手术治疗，30 例患儿接受了体外冲击波碎石术。
我们的研究结果表明，婴儿尿路结石可能表现出非特异性症状，甚至可能无症状，而阳性尿路结石家族史、泌尿系统异常、代谢紊乱、尿路感染、维生素 D 治疗和配方奶喂养可能会增加婴儿尿路结石的发生。
