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1.
Int J Infect Dis ; 90: 132-137, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31693938

RESUMO

BACKGROUND: Indirect diagnostic tests are used to assess the disease burden and to monitor the impact of different interventions in areas endemic for urinary schistosomiasis. This study was performed to assess their accuracy in the diagnosis of urinary schistosomiasis among primary school children in low and moderate transmission areas in the districts of Mpwapwa and Chakechake, respectively. METHODS: School children were interviewed regarding their history of haematuria and participation in treatment campaigns. Urine samples were collected and inspected for macro-haematuria (visual haematuria) and tested for micro-haematuria using urine reagent strips and Schistosoma haematobium eggs by urine filtration method. RESULTS: The prevalence of S. haematobium was 6.8% in Mtera Dam area and 38.7% in Uwandani Shehia. In Mtera Dam area, a history of haematuria and visual haematuria had low sensitivity (<60%) with high specificity (>90%). The urine reagent strips had high sensitivity and specificity (≥75%). In Uwandani Shehia, a history of haematuria had high sensitivity and specificity (>60%). Visual haematuria had low sensitivity (<50%) but high specificity (>80%). The urine reagent strips maintained high performance in all parameters assessed. CONCLUSIONS: The study findings suggest that urine reagent strips will continue to serve as a very useful adjunct test for monitoring the prevalence of urinary schistosomiasis in endemic areas.


Assuntos
Esquistossomose Urinária/diagnóstico , Adolescente , Animais , Anti-Helmínticos/uso terapêutico , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Feminino , Hematúria/diagnóstico , Humanos , Masculino , Praziquantel/uso terapêutico , Prevalência , Fitas Reagentes , Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/tratamento farmacológico , Esquistossomose Urinária/epidemiologia , Sensibilidade e Especificidade , Tanzânia/epidemiologia
3.
Diagn Cytopathol ; 47(11): 1223-1228, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31587518

RESUMO

Despite being an important differential diagnosis of bladder tumor on cystoscopy, follicular cystitis (FC) is rarely diagnosed on cytologic material. We performed a retrospective study on cases of FC diagnosed on bladder biopsy and/or urine cytology in our institution. A total of 35 cases of FC were identified with a female predominance (F:M = 2:1). Hematuria was the most common clinical presentation. Cystoscopic findings included mass lesions, yellow plaques, and surface erythema. History of urinary tract infection was reported in 48% of the patients, and majority of those patients had positive concurrent urine culture, most commonly with beta-hemolytic streptococcus, Group B. A total of 17 out of 35 patients had urine cytology specimens. When the presence of follicular dendritic cells in clusters of variously sized lymphocytes is used as the cytological diagnostic criterion, 6 out of 17 cases were diagnosed as FC and 5 out of 6 were confirmed by concurrent biopsy. This retrospective study not only analyzed the clinical characteristics of FC but also elucidated the cytological diagnostic criteria of FC and confirmed its specificity.


Assuntos
Cistite , Hematúria , Streptococcus agalactiae , Urina/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistite/diagnóstico , Cistite/microbiologia , Cistite/patologia , Cistite/urina , Citodiagnóstico , Diagnóstico Diferencial , Feminino , Hematúria/diagnóstico , Hematúria/microbiologia , Hematúria/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/microbiologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/urina
4.
Zhonghua Er Ke Za Zhi ; 57(9): 674-679, 2019 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-31530352

RESUMO

Objective: To examine genetic variants of familial hematuria (FH) associated genes in 3 families with hematuria with probands initially diagnosed with IgA nephropathy (IgAN). Methods: A retrospective analysis was performed on the clinical data, laboratory tests and genetic test results of three children with hematuria and the probands in three families with hematuria. The families were ascertained at the Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command from August 2014 to May 2018. Results: The proband of Family One, an 8-year-old boy, manifested gross hematuria. His renal biopsy pathology revealed IgAN. His father also manifested hematuria. Genetic testing showed that the proband and his father carried a heterozygous variant of the CFHR5 gene,533A>G (Asn178Ser). The child of Family Two, a 4-year-old girl, manifested hematuria. Her father, the proband of the family, was 36 years old, and manifested hematuria, proteinuria, high-frequency sensorineural deafness and renal insufficiency. He was diagnosed as IgAN according to clinical manifestations, renal pathology and routine immunohistochemistry without renal biopsy electron microscopy, renal tissue type Ⅳ collagen α3, α4, α5 chains immunofluorescence and skin type Ⅳ collagen α5 chain immunofluorescence. Genetic testing showed that the girl carried a heterozygous variant of the COL4A5 gene,566G>T (Gly189Val), and her father carried the hemizygous variant. The child of Family Three, a 7-year-old girl, manifested hematuria and proteinuria. Her mother, the proband of the family, was 34 years old, and manifested hematuria and proteinuria as well. The proband was diagnosed as IgAN by the same method used for Family Two. The girl's grandfather died of uremia at the age of 44. Genetic testing showed that the girl and her mother carried a heterozygous variant 539G>A (Gly180Glu)in COL4A5 gene. Conclusions: The variant of the CFHR5 gene identified in Family One is of uncertain signifance, and the two variants of the COL4A5 gene identified in Families Two and Three are pathogenic. The probands of Families Two and Three are diagnosed as Alport syndrome. The study suggests that clinicians should examine genetic variants of FH associated genes in families with hematuria when the probands were diagnosed as IgAN by their clinical manifestations, renal pathology and routine immunohistochemistry.


Assuntos
Variação Genética/genética , Hematúria/diagnóstico , Nefrite Hereditária/diagnóstico , Adulto , Criança , Pré-Escolar , Feminino , Testes Genéticos/métodos , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/patologia , Hematúria/genética , Humanos , Rim , Masculino , Nefrite Hereditária/genética , Estudos Retrospectivos , Sequenciamento Completo do Exoma
5.
Emerg Med Clin North Am ; 37(4): 755-769, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31563206

RESUMO

Hematuria is common; whether gross or microscopic, it is incumbent on emergency providers to consider life-threatening and benign processes when evaluating these patients. Most workup is driven by a focused history and physical, including laboratory studies and diagnostic imaging. The cause originates in the genitourinary tract and, as long as the patient remains stable, they can be discharged with close outpatient follow-up. The importance of this cannot be stressed enough because hematuria, especially in the elderly, frequently signals the presence of urologic malignancy. In addition, the workup occasionally yields a nongenitourinary tract cause, and these patients often require emergent management.


Assuntos
Hematúria/diagnóstico , Serviço Hospitalar de Emergência , Hematúria/etiologia , Hematúria/terapia , Humanos
7.
BMC Urol ; 19(1): 76, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387648

RESUMO

BACKGROUND: Microscopic hematuria is a common incidental finding on routine urinalysis. Although there are no clear recommendations to perform routine urinalysis, some studies have shown that up to 50% of general practitioners continue to perform annual routine urinalysis regardless of age or risk factors. The aim of this study was to identify associated factors and prevalence of dipstick microscopic hematuria in the general male population presenting to an annual public men's health fair. METHOD: We conducted a retrospective analysis of prospectively collected data at an annual Men's Health fair from 2008 to 2013. Patient reported health questionnaires, basic physical exam including digital rectal exam, basic bloodwork and dipstick urinalysis data was examined. RESULTS: A total of 979 patients were reviewed. Of these, 850 provided a urine sample and were included in the final analysis. Seventy-three (8.6%) patients had positive hematuria on urinalysis. Average age in both groups was 55 years. Presence of microscopic hematuria was correlated with presence of diabetes and proteinuria with odds-ratio of 2.8 (1.3-5.8) and 2.9 (1.7-5.0) respectively on multivariate analysis. There was no significant correlation identified with age, hypertension, coronary artery disease, body-mass index, smoking, prostate specific antigen (PSA) or International Prostate Symptom Score (IPSS). Limitation of this study is the lack of follow-up and knowledge of subsequent investigations of patients. CONCLUSION: Microscopic hematuria is a prevalent condition in the male population presenting to a health fair. The only factors associated with microscopic hematuria were diabetes and proteinuria. No association was found between hematuria and smoking, age, or lower urinary tract symptoms.


Assuntos
Hematúria/diagnóstico , Hematúria/epidemiologia , Hematúria/urina , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Urinálise/métodos
8.
J Urol ; 202(5): 899-904, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31188730

RESUMO

PURPOSE: Computerized tomography urography is used to evaluate patients with gross or microscopic hematuria. Computerized tomography urography is a high radiation dose scan and, thus, it confers a higher risk of secondary malignancy. A computerized tomography urography split bolus protocol reduces radiation exposure but it may reduce sensitivity. In this study we used a theoretical cohort of patients with hematuria in which to model the risk of missing malignancies against the benefit of averting secondary malignancies. MATERIALS AND METHODS: We calculated the prevalence of renal cell carcinoma and upper tract urothelial carcinoma in patients with hematuria by pooled analysis of cohort studies, which in conjunction with split bolus sensitivity allows for the estimation of missed malignancies. The number of prevented secondary malignancies was calculated from lifetime attributable risk estimates. Sensitivity analyses were run to determine the minimum sensitivity required for a net population benefit. RESULTS: Estimates of split bolus computerized tomography urography sensitivity ranged from 80% to 100% (mean 95.2%). At the low estimate of 80% sensitivity split bolus computerized tomography urography was beneficial in men and women with microscopic hematuria at ages less than 50 and less than 60 years, respectively. An increase in sensitivity to 90% improved the benefit 1 decade in each gender, representing 68.8% of patients with microscopic hematuria. The overall population of patients with microscopic hematuria benefited from split bolus computerized tomography urography at 91.1% sensitivity. However, in patients with gross hematuria the threshold for an overall population benefit was high at 98.4% sensitivity. CONCLUSIONS: Exposure to ionizing radiation risks causing secondary malignancy. These data indicate that split bolus computerized tomography urography may be performed safely in 70% of the population of patients with microscopic hematuria. However, it is not currently advisable in patients with gross hematuria or in other patients at high risk.


Assuntos
Hematúria/diagnóstico , Modelos Teóricos , Medição de Risco/métodos , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos , Neoplasias Urológicas/complicações , Adulto , Idoso , Feminino , Seguimentos , Hematúria/epidemiologia , Hematúria/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Exposição à Radiação , Tennessee/epidemiologia , Neoplasias Urológicas/diagnóstico
9.
Lakartidningen ; 1162019 Feb 19.
Artigo em Sueco | MEDLINE | ID: mdl-31192391

RESUMO

Frequency of cancer in the urinary organs was significantly lower in patients with macroscopic hematuria associated with bacteriuria compared to those without bacteriuria. The predictive value of macroscopic hematuria was <1% in patients ≤ 75 years of age with concomitant bacteriuria. CT-urography added no diagnostic value over and above cystoscopy in patients with macroscopic hematuria with bacteriuria.Bacteriuria with other bacteria than E. coli or S. saprophyticus was associated with findings of bladder tumors.


Assuntos
Bacteriúria/diagnóstico , Hematúria/diagnóstico , Neoplasias Urogenitais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Cistoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacotes de Assistência ao Paciente , Valor Preditivo dos Testes , Garantia da Qualidade dos Cuidados de Saúde , Fatores de Risco , Fumar , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/microbiologia , Neoplasias Urogenitais/microbiologia , Urografia
11.
Parasit Vectors ; 12(1): 298, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196145

RESUMO

BACKGROUND: Urinary schistosomiasis, caused by Schistosoma haematobium, remains a significant public health problem worldwide, despite years of efforts to control it. Haematuria is one of the notable indirect indicators of S. haematobium infection and is commonly assessed along with other routine screens using a urinary dipstick test. A portable "field friendly" electronic analyser would offer an automated and thus more objective read-out compared to visual-read dipstick methods. METHODS: Within the framework of a Phase 2 praziquantel dose finding study in preschool- and school-aged children infected with S. haematobium, in southern Côte d'Ivoire, we compared a visual-read of the urine dipstick strips (Multistix PRO, Siemens Healthcare Diagnostics) to an automated reader (CLINITEK Status+ analyser™ Siemens Healthcare Diagnostics). Urine samples were collected from 148 pre-school aged and 152 school-aged children for urinalysis. Values were compared using a linear weighted kappa statistic and Bland-Altman analysis. RESULTS: A very good correlation between the two methods for nitrites and haematuria was observed (κ coefficient of 0.88 and 0.82, respectively), while a good correlation was observed for leukocytes (κ coefficient of 0.63) A moderate to fair correlation was calculated (κ coefficient ≤ 0.6) for all other parameters. When the results were stratified according to infection intensity, the agreements were stronger from the high infection intensity sample measurements, for most of the parameters. CONCLUSION: Our results demonstrate the device's utility in detecting haematuria and nitrites but underline the need for further development of this tool in order to improve its performance in the field.


Assuntos
Hematúria/diagnóstico , Sistemas Automatizados de Assistência Junto ao Leito/normas , Kit de Reagentes para Diagnóstico/normas , Esquistossomose Urinária/diagnóstico , Urinálise/instrumentação , Animais , Criança , Ensaios Clínicos Fase II como Assunto , Costa do Marfim/epidemiologia , Feminino , Humanos , Masculino , Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/urina , Urinálise/normas
12.
Vet Clin Pathol ; 48(2): 276-281, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187512

RESUMO

Standard operating procedures, including World Health Organization guidelines for packed cell volume, are established for in-clinic laboratory tests. No independent, evidence-based guidelines exist for dipstick urinalysis; however, manufacturer's instructions state to dip the stick into urine. In veterinary medicine, small volume urine samples could preclude dipping; therefore, a single drip per pad from a pipette or syringe is often performed. This study aimed to examine the differences between these two urine application methods prior to analysis, with the hypothesis that the method type would not effect on test results of dipstick analysis. To standardize the strip analysis method, a Siemens Clinitek Status + analyzer was used with Multistix10SG dipsticks. Three investigators tested urines from 53 dogs with a range of diseases by both methods. Results were assessed for the degree of agreement between the methods and within method variability. Overall, the agreement between methods was high. Within each method, the drip method variability was higher than that of the dip method (P = 0.012). Disagreements between methods were present, with pH and blood having the lowest agreement levels. Glucose was more likely to be positive on the drip compared with the dip methodology. This study demonstrates potential clinically relevant differences between the two methods and a higher level of variability with the drip methodology. Therefore, while the drip method could be used for practical reasons (eg, low sample volumes), this study supports the manufacturer's recommended method of dipping the dip stick into urine rather than dripping urine onto each pad with a pipette or syringe.


Assuntos
Doenças do Cão/urina , Glicosúria/veterinária , Hematúria/veterinária , Proteinúria/veterinária , Urinálise/veterinária , Animais , Doenças do Cão/diagnóstico , Cães , Glicosúria/diagnóstico , Glicosúria/urina , Hematúria/diagnóstico , Hematúria/urina , Proteinúria/diagnóstico , Proteinúria/urina , Fitas Reagentes
13.
Pediatr. aten. prim ; 21(82): e71-e75, abr.-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184590

RESUMO

El síndrome del cascanueces se caracteriza por la compresión extrínseca de la vena renal izquierda, lo que impide su drenaje sanguíneo normal en la vena cava inferior. En la mayoría de los casos, la compresión de la vena renal izquierda se produce entre la aorta y la arteria mesentérica superior, denominándose síndrome del cascanueces anterior. Con menor frecuencia, la vena renal izquierda se encuentra en posición retroaórtica por lo que ocurre la compresión entre la aorta y el cuerpo vertebral, denominándose entonces síndrome del cascanueces posterior. La clínica característica es de hematuria microscópica o más frecuentemente macroscópica, sobre todo después de estar en bipedestación o tras realizar ejercicio físico. La proteinuria ortostática o la combinación de hematuria y proteinuria, dolor abdominal y varicocele izquierdo pueden ser otras manifestaciones del síndrome


The nutcracker syndrome is caused characterized by extrinsic compression of the left renal vein, which prevents its normal blood drainage in the inferior vein cava. In the majority of cases, compression of the left renal vein occurs between the aorta and the superior mesenteric artery, being called the anterior nutcracker syndrome. Less frequently, the left renal vein is in a retroaortic position, resulting in compression between the aorta and the vertebral body, which is called posterior nutcracker syndrome. The characteristic feature is microscopic hematuria or more often macroscopic, especially after being in a standing position or after physical exercise. Orthostatic proteinuria or the combination of hematuria and proteinuria, abdominal pain and left varicocele may be other manifestations of the syndrome


Assuntos
Humanos , Masculino , Criança , Hematúria/diagnóstico , Eritrócitos , Proteinúria/diagnóstico , Síndrome do Quebra-Nozes/diagnóstico por imagem , Hematúria/etiologia , Diagnóstico Diferencial
14.
Medicine (Baltimore) ; 98(18): e15303, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045764

RESUMO

RATIONALE: Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown. PATIENT CONCERNS: A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction. DIAGNOSES: Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level. INTERVENTIONS: The patient received plasma exchange and rituximab besides corticosteroids. OUTCOMES: The patient achieved complete remission of proteinuria and recovery of kidney function after the clearance of anti-PLA2R antibodies. LESSON: This case suggests a pathogenic role of anti-PLA2R antibodies in the mechanism of crescent formation in MN, which may need intensive therapy to eliminate the antibodies quickly.


Assuntos
Glomerulonefrite Membranoproliferativa/patologia , Glomerulonefrite Membranosa/patologia , Rim/patologia , Troca Plasmática/métodos , Receptores da Fosfolipase A2/antagonistas & inibidores , Idoso , Feminino , Glomerulonefrite Membranoproliferativa/sangue , Glomerulonefrite Membranoproliferativa/tratamento farmacológico , Glomerulonefrite Membranoproliferativa/imunologia , Glomerulonefrite Membranosa/sangue , Glomerulonefrite Membranosa/tratamento farmacológico , Glomerulonefrite Membranosa/imunologia , Hematúria/diagnóstico , Hematúria/etiologia , Humanos , Imunoglobulina G/sangue , Fatores Imunológicos/uso terapêutico , Rim/fisiopatologia , Síndrome Nefrótica/patologia , Proteinúria/patologia , Receptores da Fosfolipase A2/imunologia , Indução de Remissão , Rituximab/administração & dosagem , Rituximab/uso terapêutico , Resultado do Tratamento
15.
Int J Mol Sci ; 20(9)2019 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-31060307

RESUMO

Glomerular hematuria is a cardinal symptom of renal disease. Glomerular hematuria may be classified as microhematuria or macrohematuria according to the number of red blood cells in urine. Recent evidence suggests a pathological role of persistent glomerular microhematuria in the progression of renal disease. Moreover, gross hematuria, or macrohematuria, promotes acute kidney injury (AKI), with subsequent impairment of renal function in a high proportion of patients. In this pathological context, hemoglobin, heme, or iron released from red blood cells in the urinary space may cause direct tubular cell injury, oxidative stress, pro-inflammatory cytokine production, and further monocyte/macrophage recruitment. The aim of this manuscript is to review the role of glomerular hematuria in kidney injury, the role of inflammation as cause and consequence of glomerular hematuria, and to discuss novel therapies to combat hematuria.


Assuntos
Glomerulonefrite/complicações , Glomerulonefrite/fisiopatologia , Hematúria/etiologia , Hematúria/urina , Glomérulos Renais/fisiopatologia , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Animais , Biomarcadores , Glomerulonefrite/diagnóstico , Glomerulonefrite/etiologia , Hematúria/diagnóstico , Humanos , Rim/patologia , Rim/fisiopatologia , Estresse Oxidativo , Fenótipo , Prognóstico
16.
Medicina (B Aires) ; 79(2): 150-153, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31048282

RESUMO

Nutcracker syndrome is a vascular anomaly consisting in the compression of the left renal vein between the superior mesenteric artery and the aorta. Clinical features in nutcracker syndrome include pelvic pain, flank pain, haematuria, gonadal varices or simply asymptomatic. We are presenting two cases, one of them with macroscopic haematuria and flank pain and the other was studied for hypertension but with previous antecedents of left renal vein embolization in the setting of varicocele. We discuss the clinical presentation as well as diagnostic and therapeutic aspects related to this syndrome.


Assuntos
Síndrome do Quebra-Nozes/diagnóstico , Síndrome do Quebra-Nozes/patologia , Adolescente , Adulto , Angiografia por Tomografia Computadorizada/métodos , Feminino , Hematúria/diagnóstico , Humanos , Síndrome do Quebra-Nozes/terapia , Veias Renais/diagnóstico por imagem , Veias Renais/patologia
17.
J Surg Res ; 241: 317-322, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31055157

RESUMO

BACKGROUND: Children are more likely to have urinary system injury after blunt abdominal trauma (BAT) because of anatomical vulnerabilities. Urinalysis (UA) is often performed during initial evaluation to screen for injury. The purpose of this study was to determine how often finding microscopic hematuria after BAT leads to further testing and whether this indicates a significant injury. METHODS: A retrospective review of children evaluated for BAT at Children's Health from 2013 to 2017 was performed. Patients included had microscopic hematuria on initial UA. Data collected included demographics, injury data, laboratory and imaging data, and outcomes. Analysis was performed using descriptive statistics, Fisher's exact, and independent t-test. RESULTS: Of 1059 patients treated for BAT during the study period, 203 (19%) exhibited microscopic hematuria on UA during the initial workup. Most UAs resulted after imaging was completed and did not impact management (158, 78%); twenty-two (14%) of these patients had urinary injury, which were diagnosed by imaging regardless of UA results. Forty-five (22%) patients were found to have microscopic hematuria that independently led to workup for urinary injury. Of these, nine patients had a urinary system injury: 6 low-grade renal and three bladder wall injuries, none of which required surgery. Those with and without urinary injury in this group underwent similar numbers of radiographic studies. CONCLUSIONS: Microscopic hematuria on screening UA after BAT may lead to extensive workup, regardless of the presence of symptoms. In patients who receive cross-sectional abdominal imaging, preceding UA adds little to the clinical workup of children with BAT.


Assuntos
Traumatismos Abdominais/diagnóstico , Hematúria/diagnóstico , Sistema Urinário/lesões , Ferimentos não Penetrantes/complicações , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/urina , Adolescente , Criança , Pré-Escolar , Feminino , Hematúria/etiologia , Hematúria/urina , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Sistema Urinário/diagnóstico por imagem , Ferimentos não Penetrantes/urina
20.
Int J Rheum Dis ; 22(6): 1070-1076, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30957986

RESUMO

AIM: Since there are only a few reports on pediatric systemic lupus erythematosus (pSLE) in Chinese populations, therefore we retrospectively report the clinical and immunological features as well as renal outcome in Chinese pSLE. METHODS: Patients diagnosed with pSLE at Shanghai Children's Medical Center between 2001 and 2016 were evaluated and clinical data were retrospectively collected. RESULTS: A total of 102 pSLE patients were analyzed. Renal disorder including proteinuria (81.37%) and hematuria (65.69%) were most commonly identified. Class IV was the most common finding on renal biopsy. In lupus nephritis (LN), 67.21%, 78.0%, 86.0% and 94.55% achieved complete remission within 6, 12, 18 and 24 months, respectively. Furthermore, 16.67% of LN patients suffered at least one renal flare. Antinuclear antibodies were detected in nearly all patients (97.62%), followed by anti-double-stranded DNA (anti-dsDNA) antibodies (70.0%) and anti-Sjögren's syndrome A (anti-SSA) antibodies (60.64%). Oral corticosteroid (93.14%) and mycophenolate mofetil (64.71%) was used in the majority of patients. Infection (32.35%) was the main side effect caused by the medications. CONCLUSIONS: Our population-based pSLE cohort indicated that compared to other international cohorts, there was a higher prevalence of LN in Chinese pSLE. Proteinuria was the most frequent manifestation both at disease onset and during the entire clinical course. Class IV LN was the dominant renal pathological type. Nevertheless, there was a favorable renal remission rate and relatively low incidence of renal flare in our cohort. Apart from antinuclear antibodies and anti-dsDNA antibodies, anti-SSA antibodies were most frequently detected. Infection was the leading complication caused by the medications.


Assuntos
Anticorpos Antinucleares/sangue , Lúpus Eritematoso Sistêmico/diagnóstico , Nefrite Lúpica/diagnóstico , Adolescente , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Idade de Início , Biomarcadores/sangue , Criança , China/epidemiologia , Feminino , Hematúria/diagnóstico , Humanos , Hospedeiro Imunocomprometido , Incidência , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/imunologia , Nefrite Lúpica/tratamento farmacológico , Nefrite Lúpica/epidemiologia , Nefrite Lúpica/imunologia , Masculino , Ácido Micofenólico/administração & dosagem , Ácido Micofenólico/efeitos adversos , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/imunologia , Prevalência , Proteinúria/diagnóstico , Indução de Remissão , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
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