Urbani C E, Betti R
Dermatology Service, Hospital San Raffaele Resnati, Milan, Italy.
Int J Dermatol. 1996 May;35(5):349-52. doi: 10.1111/j.1365-4362.1996.tb03636.x.
The association between polythelia (supernumerary nipple) and kidney and urinary tract malformations (KUTM) is controversial. Some authors reported this association in newborns and infants. Case-control studies dealing with adult subjects are not found in the literature. The purpose of this study is to determine the frequency of the association between accessory mammary tissue (AMT) and congenital and hereditary nephrourinary defects in an adult population compared to a control group.
The study was performed in 146 white patients (123 men, 23 women) with AMT out of 2645 subjects consecutively referred to us for physical examination. The following investigations were undertaken: ultrasonographic examination of the abdomen and the kidneys, ECG, echocardiogram, roentgenogram of the vertebral column, urinalysis, and other laboratory tests. A sex- and age-matched control group without any evidence of AMT or lateral displacement of the nipples underwent the same examinations.
Kidney and urinary tract malformations were detected in 11 patients with AMT (nine men, two women) and in one control. These data indicate a significantly higher frequency of KUTM in the AMT-affected patients compared to controls (7.53% vs. 0.68%, P < 0.001). A broad spectrum of KUTM was discovered in association with AMT: adult dominant polycystic kidney disease, unilateral renal agenesis, cystic renal dysplasia, familial renal cysts, and congenital stenosis of the pyeloureteral joint.
Accessory mammary tissue offers an important clue for congenital and hereditary anomalies of the kidneys and urinary collecting systems. Patients with AMT should, therefore, be extensively examined for the presence of occult nephrouropathies.
多乳头(额外乳头)与肾脏及尿路畸形(KUTM)之间的关联存在争议。一些作者报道了新生儿和婴儿中存在这种关联。文献中未发现针对成年受试者的病例对照研究。本研究的目的是确定与对照组相比,成年人群中副乳腺组织(AMT)与先天性和遗传性肾泌尿缺陷之间关联的频率。
在连续转诊至我们处进行体格检查的2645名受试者中,对146名有AMT的白人患者(123名男性,23名女性)进行了研究。进行了以下检查:腹部和肾脏的超声检查、心电图、超声心动图、脊柱X线检查、尿液分析及其他实验室检查。一个无AMT或乳头侧方移位证据的性别和年龄匹配的对照组接受了相同的检查。
11名有AMT的患者(9名男性,2名女性)和1名对照组患者检测出肾脏和尿路畸形。这些数据表明,与对照组相比,受AMT影响的患者中KUTM的频率显著更高(7.53%对0.68%,P<0.001)。与AMT相关发现了广泛的KUTM:成人显性多囊肾病、单侧肾缺如、囊性肾发育不良、家族性肾囊肿以及肾盂输尿管连接处先天性狭窄。
副乳腺组织为肾脏和尿液收集系统的先天性和遗传性异常提供了重要线索。因此,有AMT的患者应接受全面检查以确定是否存在隐匿性肾病。