[Bilateral renal obstruction caused by cystine stones in a child with Henoch-Schönlein syndrome].
Haematuria is a typical symptom of glomerular involvement in Henoch-Schoenlein syndrome in children. The authors present an unusual case of haematuria and deterioration of renal function caused by cystine stones in a child with anaphylactic purpura. This 6 year old girl was hospitalized because of severe gastrointestinal symptoms in the course of a typical Henoch-Schoenlein syndrome. After 4 weeks of illness--the child demonstrated haematuria and oliguria with severe loin pain and a rise in serum creatinine to 5.8 mg%. Urine findings of mainly non-glomerular erythrocytes and slight proteinuria were suggestive of a non-glomerular cause of renal failure. Ultrasound examination revealed the unexpected finding of bilateral kidney obstruction caused by multiple renal stones. Cystine crystals observed under microscopic examination of the urinary sediment and a positive cyanide-nitroprusside test suggested cystinuria as the cause of nephrolithiasis. High water intake and alkalization of urine and captopril for cystine excretion reduction resulted in fast improvement of renal function and and with time complete dissolution of calculi. The symptoms of Henoch-Schoenlein syndrome resolved over several weeks, and the child did not develop any signs of glomerular involvement.
Zurowska
A
A
Kliniki Nefrologii Dzieciecej Akademia Medyczna w Gdańsku.
Czarniak
P
P
Kosiak
W
W
Bałasz
I
I
Zagozdzon
I
I
D000208:Acute Disease; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D002648:Child; D003555:Cystinuria / Q000150:complications* / Q000628:therapy; D004326:Drinking; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D007669:Kidney Calculi / Q000209:etiology*; D051437:Renal Insufficiency / Q000150:complications*
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril