[Ambulatory monitoring of arterial pressure in a group of children with reflux nephropathy of different degrees]. / Monitorización ambulatoria de la presión arterial en un grupo de niños con nefropatía por reflujo de diferente grado.

OBJECTIVE: The purpose of this study was to search for risk factors for the evolution reflux nephropathy by comparing the results of the ambulatory blood pressures in a group of children with reflux nephropathy of different degrees. PATIENTS AND METHODS: Out-patient blood pressure monitoring was performed in 31 children (15 males and 15 females) affected to different degrees by reflux nephropathy. This was done during a 24-hour period on a normal schoolday by using a Spacelabs 90207 oscilometric monitor. An appropriately sized armband was chosen for each case with the readings being programmed for every 20 minutes between 8:00 a.m. and 23:00 p.m. and every 30 minutes for the remaining readings. The mean blood pressure, blood pressure load and hyperbaric index over the 24 hour period (on all the readings obtained), activity period (0800 to 2200 hours) and the resting period (midnight to 6:00 a.m.) were calculated. The circadian variability (difference and ratio between the mean values of active and resting periods and the nocturnal fall in blood pressure as a percentage of the daytime mean value) was also determined. The children were classified into subgroups according to their degree of reflux nephropathy: Group 1) Degrees A and B of unilateral reflux nephropathy. Group 2) Degrees C and D of unilateral reflux nephropathy and Group 3) Bilateral nephropathy. Those monitorings with a percentage of erroneous readings over 30% were excluded. RESULTS: Two children were excluded because of a high percentage of erroneous readings. We could not find any significant difference among the three groups in casual blood pressure. We observed significant differences between the group formed by children with unilateral reflux nephropathy and children with bilateral reflux nephropathy in the blood pressure during the resting period. No significant differences were found among the three groups in the tensional load, hyperbaric index or the variables that determine the nightly descent in blood pressure. CONCLUSIONS: Ambulatory blood pressure monitoring allow the detection of risk factors for the evolution of reflux nephropathy; i.e., higher risk of blood pressure elevation, especially during the resting period and mainly for bilateral reflux nephropathy.

[Eosinophilic cystitis]. / Cistitis eosinofílica.

We report two cases of eosinophilic cystitis in children of 11 months and 11 and a half year of age respectively. The presenting symptoms were the emision of mucosanguinolent filaments in the urine in one case and with lower urinary tract symptoms and macroscopic hematuria in the other. Physical examination revealed in one of them a round, tough and painful mass in the hypogastric area. In one case we found peripheral blood eosinophilia. They both showed in the Urinalysis albuminuria, pyuria and hematuria, with the presence of eosinophils in one of them. Macroscopic examination presented in the two cases a tumoral, mamelonne mass in the wall of the bladded. The diagnosis was anatomopathologic due to the demonstration of an inflammatory infiltration, primarily of eosinophils. The clinical course was unfavourable in the case an hemicystectomy was practicated and self-limited in the one only symptomatic treatment was used.

[Chronic renal insufficiency secondary to infectious mononucleosis]. / Insuficiencia renal crónica secundaria a mononucleosis infecciosa.

This report describes the first pediatric case of chronic renal failure as a complication of infectious mononucleosis in a 3 1/2 year old girl. The clinical features were marked at onset by proteinuria and later by nephrotic syndrome. The evolution to chronic renal failure took about two years. In the renal biopsy, lesions characteristic of interstitial nephritis were observed, associated with focal and segmental glomeruloesclerosis and deposits of C3 in granular and discontinued form. Renal participation in infectious mononucleosis is not unusual and fundamentally it is manifested by proteinuria and abnormalities of urinary sediment, with interstitial nephritis as a characteristic lesion in the renal biopsy.

[Prune-belly syndrome in a female]. / Síndrome de "prune-belly", femenino.

Authors describe a case of newborn whose malformations of genitourinary tract of abdominal muscles deficiency and renal dysplasia make it very compatible with Prune-Belly Syndrome. The case it is exceptionally interesting because it is a female subject; and on the other hand because of its' associated malformations. The so debated pathogenic of the Syndrome is commented.

[Xanthine lithiasis in a case of Lesch-Nyhan syndrome treated with allopurinol]. / Litiasis xantínica en un caso de síndrome de Lesch-Nyham tratado con allopurinol.

Classically it is considered that vital prognosis of Lesch-Nyhan syndrome depends on renal affectation secondary to uric nephropathy. A case of Lesch-Nyhan syndrome treated with Allopurinol is described which presented multiple and bilateral renal stones by precipitation of xanthine. Treatment with Allopurinol inhibits the formation of uric acid and qualitatively renal excretion of oxypurines modifies. In special circumstances (disminution of urinary output and pH), they can precipitate and originate a radiotransparent lithiasis with uric lithiasis. Interest of this case, lies in being alert to possible xanthine stone formation in patients with a large excretion of purinics metabolites, who are treated with Allopurinol.