[Evolution of scintigraphic renal lesions in children after an episode of acute pyelonephritis].
نویسندگان
چکیده
BACKGROUND Abnormal Dimercaptosuccinic acid (DMSA) renal scintigraphy performed six months after an acute pyelonephritis (AP) is generally interpreted as scarring. AIM To perform a follow up of childhood patients showing scintigraphic renal lesions during the acute phase of pyelonephritis (within 7 days from the beginning of fever). MATERIAL AND METHODS A scintigraphic control was carried out at 5-7 months and, in case of persistent lesions, an additional late scintigraphy at 10-13 months. All patients were followed clinically for one year and those with a relapse of urinary tract infection were excluded from the study. RESULTS Eighty five patients with a median age of 8 months were included. Among these, the first scintigraphic control was normal in 59 (69%) and abnormal in 26 patients (31%). In five of these 26 patients (5/26:19%-5/85: 6%), a considerable regression of the lesions was obvious on the early control, and normalized completely on the late control. When expressing the results in kidney units, 107 showed lesions during the acute phase of infection; 69% was normal at the early control. Thirty three showed lesions persisting at the early control (31%) and 7 out of these 33 (21%) became normal on the late control (7/107: 7%). In total, 25% of the children included in the study (24% of the kidney units) remained with renal sequelae one year after the initial episode of AP. CONCLUSIONS The persistence of scintigraphic lesions six months after an episode of AP, does not necessarily correspond to permanent scars, since normalization can sometimes be observed on late controls.
منابع مشابه
Early detection of renal scarring in children with suspected pyelonephritis: Comparison of diuretic MAG3 scintigraphy (F0) and DMSAScan
Abstract Background: Screening for patients at risk of renal scarring is a challenge in children with acute pyelonephritis (APN). Diuretic Tc-99m mercaptoacetyltriglycine (MAG3) scintigraphy with zero time injection of furosemide (MAG3-F0) was observed to display focal parenchymal disorders. The advantages of MAG3 include: lower radiation dose and short duration of the test. The aim of this st...
متن کاملتعیین میزان گرفتاری پارانشیم کلیه با استفاده از سنتی گرافی قشر کلیه (اسکن DMSA) در کودکان مبتلا به پیلونفریت حاد مرکز طبی کودکان، 80-1379
Background: Urinary tract infection is a common bacterial infection in children and may lead to irreversible renal damage. TC 99-m Dimercaptosuccinic acid renal scintigraphy is the most sensitive method for diagnosing acute pyelonephritis. We designed a study to evaluate the ability of DMSA scan and ultrasonography to detect renal paranchymal lesion. Materials and Methods: 62 children 1 month t...
متن کاملارزیابی تغییرات پارانشیم کلیه با استفاده از اسکن DMSA در کودکان مبتلا به پیلونفریت حاد و رابطه آن با برخی پارامترهای بیولوژیک
Background: Early diagnosis of renal parenchymal involvement in children with acute pyelonephritis (APN) using isotope scan and early treatment may decrease or prevent development of renal parenchymal lesions. We designed this study to assess the diagnostic value of certain biologic parameters in children with first- episode of acute pyelonephritis (APN) documented by 99m Tc-dimercaptosucci...
متن کامل[Renal scars after one year of follow up in children with a first episode of acute pyelonephritis].
BACKGROUND Acute pyelonephritis in children can leave a kidney scar that eventually can lead to hypertension or renal failure. 99mTc-dimercaptosuccinic acid renal scintigraphy (RC DMSA) is a widely accepted technique to assess children with acute pyelonephritis. AIM To evaluate the presence of residual kidney scars detected through RC DMSA, in children with a first episode of acute pyelonephr...
متن کاملPrevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract
Objective: To calculate the frequencies of acute pyelonephritis and renal scarring in patients under the age of two, with first episode of urinary tract infection in a Brazilian university hospital, comparing with data reported in the international literature. Materials and Methods: Scintigraphic reports of children less than two years old submitted to Tc-DMSA renal scintigraphy in a university...
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ورودعنوان ژورنال:
- Revista medica de Chile
دوره 140 6 شماره
صفحات -
تاریخ انتشار 2012