Kemper M J, Müller-Wiefel D E
Division of Pediatric Nephrology, University Children's Hospital, Hamburg, Germany.
Pediatr Nephrol. 1996 Aug;10(4):442-4. doi: 10.1007/s004670050135.
Although nephrocalcinosis is a classical finding in primary hyperoxaluria type 1 (PH 1) associated with a poor renal survival it is exceptional in patients with PH type 2 (PH 2), characterized by a more favorable outcome. We describe an 8-month-old girl who suffered from recurrent urinary tract infections. Imaging studies revealed a profound corticomedullary nephrocalcinosis with no evidence of calculi. Urinary oxalate and D-glycerate excretion were massively elevated, while urinary glycolate or glyoxylate could not be detected, confirming the diagnosis of PH 2. Although the nephrocalcinosis progressed radiologically, renal function remained stable for over 2 years. Only further follow-up will show whether the associated nephrocalcinosis worsens the prognosis of our patient and of PH 2 in general.
尽管肾钙质沉着症是1型原发性高草酸尿症(PH 1)的典型表现,且与肾脏预后不良相关,但在2型原发性高草酸尿症(PH 2)患者中却很罕见,后者的预后更佳。我们描述了一名8个月大的女童,她反复出现尿路感染。影像学检查显示严重的皮质髓质肾钙质沉着症,未发现结石迹象。尿草酸和D-甘油酸排泄量大幅升高,而未检测到尿乙醇酸或乙醛酸,从而确诊为PH 2。尽管肾钙质沉着症在影像学上有所进展,但肾功能在2年多的时间里保持稳定。只有进一步随访才能表明相关的肾钙质沉着症是否会恶化我们这位患者以及总体上PH 2患者的预后。