Brain Tumor as a Late Outcome of a Child with Nephrotic Syndrome - Is There Any Association with Immunosuppression?

The association of idiopathic nephrotic syndrome with some malignancies has been reported. We hereunder report a child with focal segmental sclerosis who presented with brain tumor eleven years after renal presentation. A 16- year-old boy presented with nephrotic syndrome since was 5 years old. He was a steroid responder at first but became steroid dependent after subsequent relapses. He received cyclosporine for two years and then mycophenolate mofetil was added for three years. After that, he received losartan and enalapril. Four years later, he developed glioblastoma multiforme.  He passed away two years after surgical resection and chemo-radiotherapy. The occurrence of brain tumor after immunosuppressive therapy in this child might be a late sequel or a coincidence. This might be an alarm for using immunosuppressive agents more cautiously.Keywords: Glioblastoma; Immunosuppression; Mycophenolate Mofetil; Cyclosporine; Losartan; Enalapri; Nephrotic Syndrome.

Bladder Volume Wall Index In Children With Urinary Tract Infections

How to Cite This Article: Hooman N, Hallaji F, Mostafavi SH, Sharif MR, Tatarpoor P, Otukesh H. Bladder Volume Wall Index in Children with Urinary Tract Infections. J Ped. Nephrology 2013 July;1(1):18-22.Introduction: Few studies have focused on the correlation between bladder ultrasound and urinary tract infection. The aim of this study was to evaluate the bladder volume wall index in children with single or recurrent urinary tract infection.Materials & Methods: This case-control study was conducted between March 2008 and December 2009. The study was performed on one hundred children (8 boys, 92 girls) aged 4-15 years with a history of urinary tract infection and thirty-nine (20 males, 19 females) age- matched healthy children who had negative urine culture one month before investigation. The kidneys, ureters, and bladder sonography were performed in all children. Bladder volume wall index was calculated for each child and the result of 70-130 was presumed normal. Student T-test, chi-square, likelihood ratio, and risk ratio were used. P-value <0.05 was considered significant.Results: The mean bladder volume was 262.5 (±82) in recurrent urinary tract infection, 235 (±54) in single urinary tract infection, and 278 (±80) in controls (P<0.05). The bladder was thick (<70) in 37 (28 cases, 9 controls) and thin (>130) in 38 children (28 cases, 10 controls) (P>0.05). The median residual volume was not different between the two groups. The abnormal BVWI in children with vesicoureteral (VU) reflux was 75% as compared to 51% in those without VU reflux (P>0.05). There was no correlation between BVWI and age, gender, groups, vesicoureteral reflux status, or residual volume (P>0.05).Conclusions: According to our findings, the bladder volume wall index is not sensitive enough to discriminate children who are prone to urinary tract infection. Keywords: Urography; Urinary Tract Infections; Ultrasonography; Urinary Bladde

Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tehran, Iran

BACKGROUND: Pityriasis versicolor is a superficial infection of the stratum corneum which caused by a group of yeasts formerly named pityrosporium. The taxonomy of these lipophilic yeasts has recently been modified and includes seven species referred as Malassezia. The aim of this study is to compare the distribution of Malassezia species isolated from pityriasis versicolor lesions and those isolated from healthy skins. METHODS: Differentiation of all malassezia species performed using morphological features and physiological test including catalase reaction, Tween assimilation test and splitting of esculin. RESULTS: In pityriasis versicolor lesions, the most frequently isolated species was M. globosa (53.3%), followed by M. furfur (25.3%), M. sympodialis(9.3%), M. obtusa (8.1%) and M. slooffiae (4.0%). The most frequently isolated species in the skin of healthy individuals were M. globosa, M. sympodialis, M. furfur, M. sloofiae and M. restricta which respectively made up 41.7%, 25.0%, 23.3%, 6.7% and 3.3% of the isolated species. CONCLUSIONS: According to our data, M. globosa was the most prevalent species in the skin of healthy individuals which recovered only in the yeast form. However, the Mycelial form of M. globosa was isolated as the dominant species from pityriasis versicolor lesions. Therefore, the role of predisposing factors in the conversion of this yeast to mycelium and its subsequent involvement in pityriasis versicolor pathogenicity should be considered

Huge Obstructive Bladder Diverticula and Cystic Dysplastic Kidneys in a Newborn: A Challenging Dilemma

This study investigated a 63-day boy with end stage renal disease and abdominalcysts.The antenatal sonography detected anhydraminos, posterior urethral valve,and cystic dysplastic kidneys. Voiding cystourethrogram revealed two obstructivegiant diverticula which at firstlooked like enlarged renal pelvis.The patient had persistenturinary tract infection and perforation of diverticula. The dialysis was ineffectivebecause of leakage,immeasurable inflow and dwell volume, peritonitis and tunnelinfection.As a result, the availability of automated peritoneal dialysis for infantsis recommended to reduce morbidity and increasing the survival rate. Nonethelessthe giant bladder diverticules might be better managed by diverticulectomy procedure