• 제목/요약/키워드: Kidney Diseases Diagnosis

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Group B Streptococcal Renal Abscess in a 17-Year-Old Girl with Type 1 Diabetes Mellitus

  • Oh, Kyeong Eun;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.53-57
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    • 2020
  • Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.

Two cases of Neonatal Renal Venous Thrombosis (신생아 신정맥 혈전증 2례)

  • Lim Jung-Sub;Paek Kyong-Hoon;Han Hyo-Jung;Lee Jun-Ho;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook;Kim In-One
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.161-165
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    • 1997
  • Renal venous thrombosis (RVT) in neonatal period is a rare disease and usually complicated to clinical situations with reduced renal blood flow and hypercoagulability ; like acute blood loss, sepsis, shock, and birth asphyxia. RVT should be suspected in sick babies with hematuria, anemia, thrombocytopenia, enlarged kidney and acute renal failure. And the diagnosis can be confirmed by renal ultrasonography. We report two cases of neonatal renal venous thrombosis with review of literatures. One case, associated with E. coli sepsis, recovered completely, and the other, follwed respiratory distress in the neonate, revealed permanent renal functional impairment.

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Detection of Edwardsiella tarda, the Pathogenic Bacteria in Freshwater Fishes by Means of the Indirect Fluorescent Antibody Technique (간접형광항체법을 이용한 담수양식어의 병원균 Edwardsiella tarda의 검출)

  • 류해진;조우영;이청산;허강준
    • Korean Journal of Veterinary Service
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    • v.16 no.2
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    • pp.111-119
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    • 1993
  • In this study, we carried out the rapid diagnostic system based on indirect fluorescent anti-body technique (IFAT) for detection of bacterial diseases in cultured freshwater fishes. 1. When the fishes were tested with graded dilution of Edwardsiella tarda FPC 470 bacteria detection from ten fishes Injected with $4.1{\times}10^3$colony forming unit(CFU) /ml, all of them were detected by IFAT but only two fishes were recognizable by the culture method in the tested fishes injected with $4.1{\times}10^3$CFU /ml. 2. The bacteria E. tarda could be detected by IFAT method from 1 to 48hrs after Injection in the tissues tested such as kidney, liver and spleen of the fishes, whereas detection by culture method could be recognized from 1 to 48hrs after injection In the kidney and spleen but it was not possible from preinjection to 1 hr in the liver. 3. Thus, IFAT proved to be more useful technique than plate culture method in the diagnosis of Edwardsiellosis in the freshwater fishes.

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A Case of the Fanconi Syndrome with Nephrocalcinosis (Fanconi 증후군에 동반된 신석회화증 1례)

  • Kim Young-Mi;Park Seong-Shik;Lee Ju-Suk;Kim Su-Yung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.234-238
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    • 2003
  • Fanconi syndrome is a generalized functional disorder of the proximal tubule of the kidney and is characterized by aminoaciduria, glycosuria, hyperphosphaturia, dehydration, rickets, and growth failure. Nephrocalcinosis and hypercalciuria are rare manifestations of Fanconi syndrome. There is no case report of Fanconi syndrome complicated with nephrocalcinosis and hypercalciuria in Korea. A 6-year-old boy presented with genu valgum and waddling gaits for about 3 years. There was no family history of renal disease and his physical examination was normal except for genu valgum and corrected cleft lip and palate. Laboratory investigations showed generalized aminoaciduria, glycosuria, hyperphosphaturia, hypercalciuria, and low-molecular weight proteinuria including ${\beta}$-microglobulin. Serum 25-OH vitamin $D_3$ was within the normal range, and $1,25-(OH)_2$ vitamin $D_3$ was elevated. Bilateral renal medullary hyperechogenicity was demonstrated by ultrasonography. Analysis of the CLCN5 gene revealed no mutation. Here we describe a boy with Fanconi syndrome complicated with nophrocalcinosis and discuss the differential diagnosis.

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A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

Diagnosis of Systemic Lupus Erythematosus During Medical Follow-up After Urinary Screening (학교 집단 요 검사 이상으로 추적검사 중 전신 홍반 루푸스로 진단된 1예)

  • Yoon, So-Jin;Song, Ji-Eun;Shin, Jae-Il;Jeong, Il-Cheon;Lee, Jae-Seung;Shim, Hyo-Sup;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.227-232
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    • 2008
  • A 16-year-old girl presented with proteinuria and microscopic hematuria detected through mass urinary screening and was diagnosed as having suspected postinfectious glomerulonephritis by renal biopsy. However, heavy proteinuria did not respond to angiotensin converting enzyme inhibitor therapy. After 6 months, cervical lymphadenitis developed and a neck node biopsy showed subacute necrotizing lymphadenitis. After an additional 2 months, she developed facial erythema and thrombocytopenia. A repeat renal biopsy demonstrated lupus nephritis class IV. She was treated with pulse methylprednisolone(500 mg/day intravenously for 3 consecutive days) followed by oral deflazacort and monthly intravenous cyclophosphamide pulse(1 g/$m^2$) for 6 months. We report a case diagnosed as systemic lupus erythematosus(SLE) during medical follow-up after urinary screening.

Ocular Inspection Using Color Analysis in CIE Lab for Kidney Disease in Various Situations (다양한 환경 하에서 신장 질환 진단을 위한 색차 기반 찰색 방법의 제안)

  • Lee, Se-Hwan;Cho, Dong-Uk
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.35 no.4B
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    • pp.630-636
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    • 2010
  • Ocular inspection in oriental medicine, which identifies sickness by patient's skin color, is usually applied by doctor's subjective judgment. In order to reduce the subjectiveness of diagnosis, we propose a method of objective and quantitative analysis for ocular inspection. The most issued features for ocular inspection are how to identify the color of patients' face in various situations, and how to link the relation between color and sickness. For resolving these two issues, the color system of CIE Lab is adopted for analyzing and classifying the color characteristics. The classification of color features is verified by experiments on groups of patients and non-patients. The results of experiments showed that the proposed method can provide an objective means for ocular inspection using patient's skin color.

Thin Glomerular Basement Membrane Disease with Herlyn-Werner-Wunderlich Syndrome : Uterus Didelphys, Blind Hemivagina and Ipsilateral Renal Agenesis (비박형 사구체 기저막 질환이 동반된 중복 자궁 일측성 폐쇄질 및 동측 신장 무형성 증후군 ( Herlyn - Werner- Wunderlich syndrome ) 1례)

  • Kim, Myoung-Soo;Park, Yong-Jun;Park, Young-Jun;Park, Noh-Hyuck;Song, Ji-Sun;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.299-305
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    • 2007
  • Herlyn-Werner-Wunderlich syndrome(HWWs) is a rare variant of Mullerian ductal anomalies characterized by the presence of a hemivaginal septum, a didelphic uterus, and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain, and palpable mass due to hemihematocolpos. If a cystic mass is detected behind the urinary bladder in children, in association with the absence of a kidney, the diagnosis of uterus didelphys with imperforate vagina and hydrocolpos should be considered. When renal agenesis is found in asymptomatic children, the small size and the tubular shape of the uterus makes it almost impossible to evaluate uterine anomalies, so follow-up should be performed until the end of puberty. Appropriate preoperative diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of didelphic uterus with blind hemivagina and ipsilateral renal agenesis with biopsy- proven thin glomerular basement membrane disease which is not related to the above syndrome.

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Risk Factor's Affecting long-term Outcome of Alport syndrome (Alport 증후군의 예후와 관련된 위험요인 분석)

  • Byun Ji-Yoon;Baek Seoung-Yon;Lee Young-Mock;Kim Ji-Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo;Kim Soon-Il;Kim Yu-Seun;Park Ki-Il
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.164-175
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    • 2001
  • Purpose : Alport syndrome is a hereditary nephrotic disease characterized by progressive nephrotic symptom, sensorineural hearing loss, ophthalmic abnormality, typical microscopic findings, and familial occurrence. In this study, we tried to find the risk factors related with its prognosis by taking a close observation on clinical symptoms of children with Alport syndrome reviewing retrospectively. Materials & methods : We chose children diagnosed as Alport syndrome in renal biopsy during 20 years(from 1980, Jan. until 1999, Dec.) who could receive follow up studies in tile department of pediatrics. They were divided into two groups by comparing renal function at the time of diagnosis and at current status. We compared several clinical aspects in them, and applied nonparametric test for statistical analysis. Results : The sex ratio(male:female) of 24 children was 3:1. The most common clinical symptom presented at their first visit was gross hematuria. Among those 24 children, 11 cases($46\%$) of progressing into chronic renal failure(Group II) were observed. Hypertension, proteinuria and edema were seen much frequently in group II. The level of serum protein, albumin, and creatinine clearance were decreased while BUN, creatinine were relatively increased. All the results were statistically significant. Conclusion Clinically significant risk factors related to prognosis in Alport syndrome were the presence of hypertension, edema, and proteinuria at the time of diagnosis. Also, the level of serum protein, albumin, BUN, creatinine, and glomerular filtration rate were proved to be important factors in predicting prognosis. We believe that studies on these possible risk factors would be of great help in treating and predicting prognosis of children suffering with Alport syndrome. (J Korean Soc Pediatr Nephrol 2001;5 : 164-75)

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Treatment for Urinary Tract Infection of Children in Korea (우리나라 어린이 요로 감염의 치료 행태)

  • Kang, Hee-Gyung;Kim, Kwang-Myung;Cheong, Hae-Il;Choi, Hwang;Choi, Yong
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.15-21
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    • 2001
  • Purpose : Urinary tract infections (UTIs) of children require prompt and correct diagnosis and treatment to reduce the risk of renal damage. As a first step to improve the outcome of UTI in Korea, we investigated the practical variations in the methods of diagnosis, treatment, and evaluation of children with UTI and UTI prevention. Method :A questionnaire related to the individual policy on UTI diagnosis. treatment, imaging test, and prevention was submitted to 26 experts. Result Majority of the experts used bag-collected urine specimen for infants and mid-stream urine specimen for children for urinary culture. With a negative result of culture study, they diagnosed UTI when there was pyuria, positive results of the nitrite test, or bacteriuria. 80 $\%$ of experts prescribed prophylactic antibiotics after upper tract UTI. Operative treatment of vesicoureteral reflux (VUR) was indicated for children older than one or two years old with high-grade VUR, refractory breakthrough infections, or recurrent UTIs. Most of them performed kidney ultrasonography on the diagnosis of UTI and more than half of them evaluated children treated of UTI with vesicocystourethrogram and/or DMSA scintigraphy. Majority did not recommend circumcision. Half of the experts were screening siblings of VUR patients. Conclusion : Considering the variations exposed through this study systematic guidelines for management of children with UTI in Korean would be necessary. (J. Korean Soc Pediatr Nephrol 5 : 15-21, 2001)

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