1.Etiological analysis of asymptomatic hematuria in 431 children and follow-up
Zhicai SUN ; Yuling LIU ; Xiaofen PAN ; Guomo LI ; Xinyan LEI
Journal of Clinical Pediatrics 2015;(9):810-812
ObjectiveTo investigate the etiology and prognosis of asymptomatic hematuria in children.MethodsThe etiological factors, clinical features and prognosis of asymptomatic hematuria were analyzed retrospectively in 431 children from Jan. 2001 to Dec . 2014. ResultsIn 431 children (197 males and 234 females) with asymptomatic hematuria, the mean age of ifrst visit was 5.52±2.77 years (8 months-17 years). Four hundred and twenty-ifve cases had persistent microscopic hematuria and 6 cases had gross hematuria. Three hundred and iffteen cases (73.1%) were glomerular hematuria, among which 286 cases were isolated hematuria, 5 cases were acute glomerulonephritis, 13 cases were minimal change glomerulopathy, 4 cases were IgA nephropathy, 4 cases were mesangial proliferation glomerulonephritis and 3 cases were thin basement membrane nephropathy. One hundred and thirty-six cases (31.5%) were non-glomerular hematuria, among whom 113 cases were left renal vein entrap-ment syndrome, 17 cases were idiopathic hypercalciuria, 4 cases were kidney stone, 1 case was urinary tract infection and 1 case was left kidney absence. The mean follow-up period was 3.05±2.69 years (0.5-13.5 years). One hundred and forty-ifve patients showed the resolution of microscopic hematuria, among whom 110 cases (75.8%) had the resolution in 3 years after the ifrst visit. In 24 cases with family history of hematuria, only 6 cases showed the resolution. At the end of the follow-up, renal function remained stable in all children.ConclusionsThe onset age of asymptomatic hematuria in children varies widely, and most of them are glomerular hematuria. Most children with isolated hematuria show resolution within three years after the ifrst visit. The children with familial hematuria may last longer. The isolated hematuria has good prognosis but needs to be followed up.
2.Three cases report and literature review of X-Linked agammaglobulinemia
Xiaolin LI ; Simao FU ; Yuling LIU ; Li ZHANG ; Guomo LIN ; Xiaofen PAN
Journal of Clinical Pediatrics 2014;(7):690-693
Objective To analyze the clinical features, diagnosis and treatment of X-Linked Agarnmaglobulinemia (XLA). Methods Clinical features, cellular and humoral immune functions, treatment and prognosis from 3 patients with XLA were retrospectively reviewed. Results The age of onset were from 11 months to 6 years in these 3 cases, however, the median age of diagnosis was 12 years. All patients showed multiple recurrent bacterial infections, arthritis involved large joints such as knee, ankle, elbow and hip. Laboratory examination revealed the decrease of serum gammmaglohulin and absence of B lymphocytes in the peripheral blood. All 3 patients were identiifed BTK mutations, which were frameshift mutation and nonsense mutation in exon 3, frameshift mutation in exon 10, missense mutation in exon 18. After XLA was diagnosed, the patients were managed by intravenous gammagloulin (IVIG) replacement. The non-steroidal anti-inflammatory drugs (NSAIDs) were administrated in patients combined arthritis. The small dose of hormones had been applied. All patients had a significantly improvement. Conclusions The clinical features of XLA have greater variability, with recurrent bacterial infections. Markedly decreased and absent tosils and lymph nodes, serum immunoglobulin may be one of the warning signs for early diagnosis of XLA. IVIG and NSAIDs can be jointly treatment of XLA with arthritis. The steroid and immunosuppressant agents should be used with caution.