Recurrent macroscopic hematuria and abdominal pain: Questions and answers

A 6.5 yr old girl was admitted with a category of clinical signs and symptoms including recurrent gross hematuria, ab-dominal pain, and fever. After different examinations including genetic analysis, the disease was diagnosed as Familial Mediterranean fever (FMF). It is suggested to consider FMF as a rare cause of recurrent gross hematuria, which is re-sponsive to colchicine treatment. © 2015, Iranian Journal of Public Health. All rights reserved

Polycystic kidney and down syndrome

Kidney disease is not a common complication in Down Syndrome (DS). A variety of renal and urologic problems have been described in these patients and some develop renal failure. Coincidence of polycystic kidney disease and DS is a rare entity. This is a report of a 3.5-month-old infant with DS, known to have early end-stage renal failure due to polycystic kidney disease

Effect-directed analysis for the antioxidant compound in Salvia verticillata

Salvia genus is one of the largest genera of the Lamiaceae family. Its species have been used for a wide variety of disorders in the local traditional medicine systems. Therefore, the genus has been the subject of several phytochemical and biological studies. The aim of the study was to identify the major antioxidant compound(s) from the methanol extract of Salvia verticillata using activity-guided fractionation. The crude extract showed strong antioxidant activities in DPPH and β-carotene/linoleic acid tests. The ethyl acetate fraction also exhibited a potent free radical scavenging activity compared to the other fractions. Further fractionation and purification of the ethyl acetate fraction using chromatography methods yielded a compound with high antioxidant capacity. The isolated active compound was determined as chrysoeriol. It showed a dose-dependent free radical scavenging activity with an IC50 (DPPH scavenging) value of 93.32 (80.23-108.57) mM. © 2016 by School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services

Pattern of inheritance of idiopathic hypercalciuria in two families

Idiopathic hypercalciuria is a leading cause of frequency-dysuria syndrome in childhood. Different modes of inheritance have been suggested in this disease. This article presents the occurrence of idiopathic hypercalciuria in all children of two families. In the first family, a 5.5 year old girl with a history of renal stones and dysuria due to hypercalciuria, had two involved brothers and one sister. In the second family, hypercalciuria and medullary nephrocalcinosis were detected in two siblings who were admitted for polyuria and dysuria. Idiopathic type of hypercalciuria was diagnosed in these two families by normal laboratory exams and exclusion of other causes of normocalcemic hypercalciuria. According to the involvement of all offsprings (both sexes) in these two families, it is suggested that idiopathic hypercalciuria is an autosomal dominant disease with complete penetration. © 2006 Tehran University of Medical Sciences. All rights reserved

Clinical course and effective factors of primary vesicoureteral reflux

Vesicoureteral reflux (VUR) is one of the most important causes of urinary tract infection and renal failure in children. It is a potentially self-limited disease. The aim of this study was to evaluate the clinical course and significant factors in children with primary VUR. The medical charts of 125 infants and children (27.2 males, 72.8 females) with all grades of primary VUR were retrospectively reviewed. Mean age at diagnosis was 22.3±22.9 months. 52 of patients had bilateral VUR. Mild reflux (Grade I, II) was the most common initial grade. 53.6 of patients achieved spontaneous resolution. 30.1 of patients had decreased renal function on initial DMSA renal scan, significantly in males and severe VUR. Reflux nephropathy occurred in 17.6 of patients, especially in renal damage and male sex. No significant association was observed between recurrent urinary tract infection with the severity of VUR, and the presence of renal damage at admission. Age at diagnosis, gender, grade, laterality, the absence of recurrent urinary tract infection and renal damage had a significant correlation between spontaneous VUR resolution. Spontaneous resolution of primary VUR occurred significantly in female patients, age � 30months at diagnosis, mild-to-moderate VUR, unilateral reflux, the absence of recurrent urinary tract infection, and renal damage. © 2015 Tehran University of Medical Sciences. All rights reserved

Validity of neutrophil gelatinase associated lipocaline as a biomarker for diagnosis of children with acute pyelonephritis

Purpose: Novel biomarkers have been investigated for various renal disorders, including urinary tract infection (UTI). The aim of this study was to assess whether urine neutrophil gelatinase associated lipocaline (NGAL), could represent a reliable biomarker for diagnosis and treatment of children with acute pyelonephritis (APN). Materials and Methods: A total of 37 children (32 females, 5 males) with APN were included in this prospective study. Urine NGAL was measured before and 5-7 days after antibiotic treatment in the UTI group, using ELISA kit and compared with 26 (8 females, 18 males) control group children admitted for other bacterial infections. Results: Mean age of the UTI group was 39 � 28 months, compared to 43.6 � 31.5 months for the control group with no statistically significant difference. Median urine NGAL level was significantly higher in patients with APN than the other subjects 0.48 (interquartile range (IQR): 0.15-0.72) vs. 0.065 (0.01-0.24), P = .001, and decreased significantly after antibiotic treatment (P = .002). Using a cutoff of 0.20 ng/mL, sensitivity and specificity of urine NGAL were 76% and 77% for prediction of APN, respectively. The area under the ROC curve (AUC) for urine NGAL was 0.75 (CI= 0.61-0.88), suggesting urine NGAL as a relatively good predictive biomarker of APN. Conclusion: Urine NGAL is a good biomarker for diagnosis and treatment monitoring of APN in children

Recurrent Henoch-Schönlein purpura in familial mediterranean fever

Familial Mediterranean fever (FMF) is a relatively rare disorder, characterized by recurrent self-limited attacks of fever and polyserositis. Diagnosis is made by clinical features, gene identification on chromosome 16 and clinical response to specific treatment. Different types of vasculitis have been reported in FMF. Henoch-Schönlein purpura (HSP) is one of them, usually with a benign clinical course. Repeated attacks of HSP have been rarely reported in FMF. This is the report of a 7-year-old girl who presented initially with recurrent fever and abdominal pain. After the primary diagnosis of FMF and appropriate treatment, she experienced two documented repeated attacks of HSP with severe renal involvement (crescentic glomerulonephritis) and protracted abdominal pain in the second one. Glomerulonephritis was controlled by methyl-prednisolone pulse therapy plus oral corticosteroid and azathioprine, but abdominal pain was resistant to steroids and revealed completely by intravenous immunoglobulin (IVIg) administration. In conclusion, it is suggested to consider the recurrence of HSP in cases with FMF to prevent irreversible renal complications. IVIg seems to be a good choice for the management of intractable abdominal pain of HSP. © 2008 Tehran University of Medical Sciences. All rights reserved

Predictive factors of acute renal failure in the neonates with respiratory distress syndrome

Background: Preterm birth occurs in a large number of pregnancies, and its incidence has been reported to be on the rise. Acute kidney injury (AKI) is a common complication in the premature infants with respiratory distress syndrome (RDS). The present study aimed to determine the predictive factors, clinical courses, and outcomes of AKI in the neonates with the clinical and radiological manifestations of RDS. Methods: Medical records of 84 premature neonates with RDS were evaluated in two groups of case (with AKI) (n=34) and control (without AKI) (n=50). Diagnosis of AKI was based on the increased level of serum creatinine (>1.5 mg/dL) after the third day of birth or increasing serum creatinine level. In addition, blood pressure and laboratory findings, including complete blood count, serum electrolytes, and urine volume, were compared between the two groups. Results: Mean age of the infants with AKI was 5.41±3.29 days, and the majority of the patients had nonoliguric renal failure. Among the samples, 23.5 died, and 76.5 were discharged without renal impairment. Birth weight, systolic blood pressure, blood urea nitrogen, calcium, and pH on admission had significant correlations with the presence of AKI. Moreover, birth weight was observed to be a relatively accurate predictive factor for AKI (AUC=0.08; 95 CI=0.68-0.91), with 73.5 sensitivity and 80 specificity. Conclusion: According to the results, AKI was more common in the low-birth-weight infants with severe RDS compared to the other subjects. © 2018 Mashhad University of Medical Sciences. All rights reserved