Bilateral ureteric obstruction secondary to renal papillary necrosis.
A 2-year-old male presented to hospital with a 5-day history of vomiting and pyrexia. He was initially treated with non-steroidal medication as an anti-pyretic. Initial investigations demonstrated a raised urea and creatinine and he was treated with intravenous fluids. Within 24 h he became anuric with progressive renal insufficiency. Ultrasound scan demonstrated minimal bilateral hydronephrosis with debris in the lower pole calyces. The bladder was empty. Cystoscopy and retrograde contrast imaging revealed bilateral ureteric obstruction. Double J stents were inserted and his renal function returned to normal within 4 days. We believe the aetiology to be renal papillary necrosis and bilateral ureteric obstruction secondary to the administration of ibuprofen in association with dehydration.
Broadis
Emily
E
Royal Hospital for Sick Children, Glasgow, UK. EBroadis@doctors.org.uk
Barbour
Louise
L
O'Toole
Stuart
S
Fyfe
Alasdair
A
Flett
Martyn
M
Irwin
Greg
G
Ramage
Ian J
IJ
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D003681:Dehydration / Q000150:complications; D003937:Diagnosis, Differential; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects; D007223:Infant; D007681:Kidney Papillary Necrosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen