Increased renal reflectivity in sickle cell disease: prevalence and characteristics.
Renal ultrasound appearances have been examined in 315 patients with sickle cell disease aged 10-20 years, followed in a cohort study from birth. There were three different echo patterns. A normal appearance (type 1) occurred in 235 (75%) of all subjects, and in 159/179 (89%) with homozygous sickle cell (SS) disease. A diffuse increase in reflectivity throughout the kidney (type 2), similar to that of adjacent liver, occurred in 17 patients (5%). Widespread confluent or focal increase in reflectivity confined to the renal medulla (type 3) occurred in 63 (20%) of the total group, and was much more common in the mild genotypes of sickle cell-haemoglobin C disease (41/111, 37%) and sickle cell-beta+ thalassaemia (15/19, 79%) than in SS disease (5/179, 3%). We speculate that type 2 changes may reflect diffuse glomerular and interstitial fibrosis, and that type 3 resembles changes seen in sub-clinical nephrocalcinosis, and could be due to iron deposition.
Walker
T M
TM
Department of Radiology, Royal Berkshire Hospital, Reading, UK.
Serjeant
G R
GR
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000000981:diagnostic imaging*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006450:Hemoglobin SC Disease / Q000000981:diagnostic imaging; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D014463:Ultrasonography