Aliabadi H, Gonzalez R, Quie P G
Department of Urologic Surgery, University of Minnesota Hospital and Clinic, Minneapolis 55455.
N Engl J Med. 1989 Sep 14;321(11):706-8. doi: 10.1056/NEJM198909143211102.
Twelve of the 25 patients with chronic granulomatous disease treated at our institution between 1957 and 1987 were found to have urinary tract disorders. All 12 patients were male and 22 years of age or younger when chronic granulomatous disease was diagnosed. Six patients had hydroureteronephrosis in association with recurrent episodes of pyelonephritis, retroperitoneal lymphadenitis, and granuloma formation. The other six patients had genital lesions or dysuria. Among the six patients with hydroureteronephrosis, a nephrectomy was performed in two, ureterolysis was used to relieve obstruction in one, and hydroureteronephrosis resolved after antibiotic therapy alone in three. We conclude that complications involving the genitourinary system occur frequently in patients with chronic granulomatous disease. Periodic imaging of the urinary tract may detect asymptomatic hydroureteronephrosis or other treatable genitourinary abnormalities in these patients.
1957年至1987年间在我们机构接受治疗的25例慢性肉芽肿病患者中,有12例被发现患有泌尿系统疾病。所有12例患者均为男性,在慢性肉芽肿病被诊断时年龄为22岁或更小。6例患者出现输尿管肾盂积水,并伴有肾盂肾炎反复发作、腹膜后淋巴结炎和肉芽肿形成。另外6例患者有生殖器病变或排尿困难。在6例输尿管肾盂积水患者中,2例行肾切除术,1例行输尿管松解术以解除梗阻,3例仅经抗生素治疗后输尿管肾盂积水即消退。我们得出结论,慢性肉芽肿病患者常发生涉及泌尿生殖系统的并发症。对这些患者定期进行泌尿系统影像学检查可能会发现无症状的输尿管肾盂积水或其他可治疗的泌尿生殖系统异常。