Krzemień Grażyna, Turczyn Agnieszka, Pańczyk-Tomaszewska Małgorzata, Jakimów-Kostrzewa Aleksandra, Szmigielska Agnieszka
Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.
Department of Pediatric Radiology, Medical University of Warsaw, Poland.
Dev Period Med. 2017;21(4):380-383. doi: 10.34763/devperiodmed.20172104.380383.
In patients with autosomal dominant polycystic kidney disease (ADPKD) coexisting abnormalities of the urinary tract are considered rare. Only a few patients with ADPKD and congenital abnormalities of the kidney and urinary tract- renal agenesis, hypoplasia, aplasia, horseshoe kidney, ectopic multicystic dysplasic kidney, or subpelvic junction obstruction were reported. Renal agenesis occurs in approximately 1 in 1.500.000-3.000.000 patients with ADPKD. We report a boy with ADPKD and renal agenesis diagnosed at the age of 12 years. ADPKD was diagnosed in some other members of the family. Additionally to kidney changes, mitral valve prolapse was found on echocardiography. At the age of 18 years high normal blood pressure was recognized and laboratory tests demonstrated: serum creatinine 1.0 mg/dl, glomerular filtrate rate 97.9 ml/min/1.73m2 , isotopic creatinine clearance (Tc-99mDTPA) 99 ml/min/1.73m2 , normal urinalysis, no microalbuminuria.
In children with positive family history of ADPKD, screening ultrasonography of the kidney performed at the request of the family, allows the early diagnosis of sporadic present abnormalities of the kidney and urinary tract.
在常染色体显性多囊肾病(ADPKD)患者中,尿路并存异常被认为很罕见。仅有少数ADPKD合并肾脏和尿路先天性异常(肾缺如、发育不全、发育不全、马蹄肾、异位多囊性发育不良肾或骨盆下连接处梗阻)的患者被报道。肾缺如在每150万至300万例ADPKD患者中约有1例发生。我们报告一名12岁时被诊断为ADPKD和肾缺如的男孩。该家族的其他一些成员也被诊断出患有ADPKD。除肾脏改变外,超声心动图检查发现二尖瓣脱垂。18岁时发现血压略高于正常,实验室检查显示:血清肌酐1.0mg/dl,肾小球滤过率97.9ml/min/1.73m²,同位素肌酐清除率(Tc-99m DTPA)99ml/min/1.73m²,尿常规正常,无微量白蛋白尿。
对于有ADPKD家族史阳性的儿童,应家族要求进行肾脏筛查超声检查,有助于早期诊断散发性肾脏和尿路异常。