Uçar B, Yakut A, Kural N, Büyükaşik F, Vardareli E
Osmangazi University, Faculty of Medicine, Department of Pediatrics, Eskişehir, Turkey.
Pediatr Nephrol. 1997 Feb;11(1):31-5. doi: 10.1007/s004670050228.
We report five patients with Laurence-Moon-Bardet-Biedl syndrome (LMBBS) who had renal involvement. Intravenous pyelography showed bilateral or unilateral calyceal clubbing and blunting in all patients. In addition, one patient had a parapelvic cyst in the left kidney and another had bilateral lobulated renal outlines of the fetal type. One patient had a urinary concentrating defect and two patients showed increased fractional sodium excretion. Estimated tubular phosphate reabsorption values were in normal limits in all of five patients. No patient had a urine acidification defect, proteinuria, glycosuria, or hyperaminoaciduria. One patient died from end-stage renal failure. The remaining four patients had normal serum creatinine values and estimated creatinine clearances. 99mTechnetium-diethylenetriamine pentaacetate renal scanning showed prolonged and delayed concentration and delayed excretion in three of the four patients who survived. A focal scar was determined on the left kidney of one of four patients by 99mtechnetium-dimercaptosuccinic acid renal scanning. All LMBBS cases with or without renal symptoms should be routinely evaluated for renal abnormalities. Renal scanning is a valuable method, especially for determining the renal involvement in the early stage of disease.
我们报告了5例患有劳伦斯-穆恩-巴德-比德尔综合征(LMBBS)且有肾脏受累的患者。静脉肾盂造影显示所有患者均有双侧或单侧肾盏杵状变钝。此外,1例患者左肾有肾盂旁囊肿,另1例患者双侧肾脏呈胎儿型分叶状轮廓。1例患者有尿浓缩功能缺陷,2例患者尿钠排泄分数增加。5例患者的肾小管磷重吸收估计值均在正常范围内。所有患者均无尿酸化功能缺陷、蛋白尿、糖尿或高氨基酸尿。1例患者死于终末期肾衰竭。其余4例患者血清肌酐值和肌酐清除率估计值均正常。99m锝-二乙三胺五乙酸肾扫描显示,4例存活患者中的3例出现浓聚延长和延迟以及排泄延迟。4例患者中的1例通过99m锝-二巯基丁二酸肾扫描在左肾发现一个局灶性瘢痕。所有有或无肾脏症状的LMBBS病例均应常规评估肾脏异常情况。肾扫描是一种有价值的方法,尤其对于确定疾病早期的肾脏受累情况。