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因青少年特发性脊柱侧凸支具治疗导致晨尿中出现蛋白尿。

Proteinuria from first-morning urine in a child due to brace treatment for adolescent idiopathic scoliosis.

机构信息

Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

CEN Case Rep. 2022 Nov;11(4):490-493. doi: 10.1007/s13730-022-00708-z. Epub 2022 May 9.

Abstract

A first-morning urine test for screening urinary protein is important for distinguishing whether asymptomatic proteinuria, which is a common finding in school-aged children, is caused due to kidney disease or not. We report the case of a 12-year-old Japanese girl who was referred to our pediatric department for asymptomatic proteinuria detected during a school urinary screening. Proteinuria was found only on the first-morning urinalysis and not on the routine urinalysis. The patient had been diagnosed with adolescent idiopathic scoliosis and treated with a nighttime brace. As excess protein was not detected on urinalysis of the first-morning urine sample that was collected after a night without the brace, proteinuria due to the brace treatment for scoliosis was diagnosed. The present case revealed that brace treatment can cause proteinuria. Even if a first-morning urine is positive for protein, an unexpected cause can trigger asymptomatic proteinuria in a growing child.

摘要

晨尿检测用于筛查尿蛋白,对于鉴别无症状性蛋白尿(在学龄儿童中常见)是否由肾脏疾病引起非常重要。我们报告了一例 12 岁日本女孩的病例,该女孩在学校尿液筛查中发现无症状性蛋白尿,随后被转至我院儿科就诊。仅在首次晨尿分析中发现蛋白尿,而常规尿液分析中未发现。该患者曾被诊断为青少年特发性脊柱侧凸,并接受夜间支具治疗。由于在夜间不佩戴支具收集的首次晨尿样本的尿液分析中未检测到过量蛋白质,因此诊断为脊柱侧凸支具治疗引起的蛋白尿。本病例揭示了支具治疗可能会导致蛋白尿。即使首次晨尿蛋白阳性,在生长发育中的儿童中,意料之外的原因也可能引发无症状性蛋白尿。

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Effective factors on brace compliance in idiopathic scoliosis: a literature review.特发性脊柱侧凸支具治疗依从性的影响因素:文献综述。
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本文引用的文献

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Renal vein obstruction and orthostatic proteinuria: a review.肾静脉阻塞和直立性蛋白尿:综述。
Nephrol Dial Transplant. 2011 Feb;26(2):562-5. doi: 10.1093/ndt/gfq444. Epub 2010 Jul 23.
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Adolescent idiopathic scoliosis.青少年特发性脊柱侧凸
Lancet. 2008 May 3;371(9623):1527-37. doi: 10.1016/S0140-6736(08)60658-3.

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