Mohkam Masoumeh, Jamee Mahnaz, Kompani Farshid, Khalili Mitra, Seifi Atena, Mohajerzadeh Leily
Pediatric Nephrology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pediatric Nephrology, Golestan University of Medical Sciences, Golestan, Iran.
Case Rep Nephrol. 2022 May 4;2022:9562671. doi: 10.1155/2022/9562671. eCollection 2022.
Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. . Here, we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultrasonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis, or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection.
Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.
先天性肾积水是上尿路最常见的异常之一，可由多种内在或外在诱因加重。泌尿系统是新冠病毒感染的主要受累器官之一。在此，我们报告5例确诊为先天性肾积水的患者，他们均出现急性腹痛、发热，且盆腔前后径（APD）突然增大。这些患者既往病情稳定，一直通过系列超声检查进行定期随访。由于肾积水病情后来加重，他们接受了手术或支持治疗。根据临床和影像学检查结果，无法推测出这些病情加重发作的合理病因，包括感染、肾结石或腹部肿块。所有这些患者的共同之处在于存在新冠病毒感染的证据。
产前肾积水患儿感染新冠病毒可能会加重肾积水程度及超声检查中的肾脏APD，这本身可能是由炎症介质增加介导的。
