[Urinary calculi in children: contribution of anamnesis, biological exploration and physical analysis of calculi to the etiological diagnosis].
BACKGROUND
It is always of importance to define the cause of urinary calculi disease in children to prevent recurrence and possible impairing of renal function. Nevertheless, etiology is not always easy to prove and must be deduced from both clinical and biological arguments.


METHODS
The aim of this prospective study including 39 Tunisian children with urinary stones was to identify etiology and stone risk factors and detail the part of clinical and biological data and results of physical analysis of stones in determining the cause of the stone.


RESULTS
In 31 cases among 39, clinical and biological data were not sufficient to identify clearly the stone etiology. When considering the structure and stone composition, the cause of the stone could be determined in 97.4% of the cases. An inherited disease was found responsible for the stone in 11 children, urinary tract infection in 13 cases, idiopathic hypercalciuria in nine cases and a nutritional deficiency disease in seven cases. In one case, polycystic kidney disease with metabolic risk factors could explain the stone process. No precise etiology was found in one case. Among infection stones, struvite stones could be related to urea-splitting bacteria while other calculi, containing whitlockite and protein matrix could be related to other micro-organisms. Earlier severe chronic diarrhoea episodes were noted in six among seven children presenting stones with a nucleus mainly composed of ammonium urate.


CONCLUSIONS
Clinical data, biological data from both urine and blood of the patients and also the structure and composition of the stones are needed to identify the cause of urinary calculi. Such a procedure could provide the stone etiology in most cases.
Kamoun
A
A
Service de pédiatrie, hôpital Charles-Nicolle, Tunis, Tunisie.
Zghal
A
A
Daudon
M
M
Ben Ammar
S
S
Zerelli
L
L
Abdelmoula
J
J
Chaouachi
B
B
Houissa
T
T
Belkahia
C
C
Lakhoua
R
R
D000293:Adolescent; D000704:Analysis of Variance; D002118:Calcium / Q000652:urine; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008487:Medical History Taking; D008661:Metabolism, Inborn Errors / Q000150:complications; D011446:Prospective Studies; D000644:Quaternary Ammonium Compounds / Q000652:urine; D012307:Risk Factors; D014416:Tunisia; D014527:Uric Acid / Q000652:urine; D014545:Urinary Calculi / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D014552:Urinary Tract Infections / Q000150:complications
D000644:Quaternary Ammonium Compounds; D014527:Uric Acid; D002118:Calcium