A Contrast Nephropathy in a Preterm Infant Following Preoperative Embolization of Giant Sacrococcygeal Teratoma.
10.3339/jkspn.2017.21.1.26
- Author:
Byong Sop LEE
1
Author Information
1. Department of Pediatrics University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. mdleebs@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Acute kidney injury;
Contrast-induced nephropathy;
Sacrococcygeal teratoma;
Premature infant;
Therapeutic embolization
- MeSH:
Acute Kidney Injury;
Creatinine;
Embolization, Therapeutic;
Follow-Up Studies;
Heart Failure;
Hemodynamics;
Humans;
Infant;
Infant, Newborn;
Infant, Premature*;
Parturition;
Pregnancy;
Renal Insufficiency;
Risk Factors;
Teratoma*
- From:Childhood Kidney Diseases
2017;21(1):26-30
- CountryRepublic of Korea
- Language:English
-
Abstract:
Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient's serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients.
