Neurogenic bladder findings in patients with Congenital Zika Syndrome: A novel condition

Autor: Marcia Cristina Bastos Boechat, Ana C. Monteiro, Lúcia Maria Costa Monteiro, Maria Elizabeth Lopes Moreira, Tania Regina Dias Saad Salles, Glaura O. Cruz, Juliana Marin Fontes
Jazyk: angličtina
Rok vydání: 2018
Předmět:
RNA viruses
Central Nervous System
Male
Microcephaly
030232 urology & nephrology
lcsh:Medicine
Pathology and Laboratory Medicine
Nervous System
Zika virus
0302 clinical medicine
Medicine and Health Sciences
Morphogenesis
030212 general & internal medicine
Urinary Tract
lcsh:Science
Upper urinary tract
Multidisciplinary
Urinary bladder
biology
Zika Virus Infection
medicine.anatomical_structure
Overactive bladder
Medical Microbiology
Viral Pathogens
Urinary Tract Infections
Viruses
Female
Anatomy
Pathogens
Research Article
medicine.medical_specialty
Urinary system
Bladder
Urology
Central nervous system
Microbiology
03 medical and health sciences
Internal medicine
medicine
Congenital Disorders
Humans
Birth Defects
Urinary Bladder
Neurogenic
Microbial Pathogens
Disease burden
Flaviviruses
business.industry
lcsh:R
Organisms
Biology and Life Sciences
Infant
Renal System
Zika Virus
medicine.disease
biology.organism_classification
Urodynamics
lcsh:Q
business
Developmental Biology
Zdroj: PLoS ONE, Vol 13, Iss 3, p e0193514 (2018)
PLoS ONE
ISSN: 1932-6203
Popis: Introduction Congenital Zika Syndrome (CZS) has been associated with microcephaly and other central nervous system abnormalities including areas that have been implicated in the control of the lower urinary tract. As such, this descriptive case series has aimed to investigate whether CZS is linked with neurogenic bladder. Identifying such an association is paramount in the effort to recognize CZS complications that have putative treatment options that could mitigate the impact of CZS in infected children. Methods Following IRB approval, urological assessment was performed in all patients referred to our clinic between June 2016 and May 2017 who presented with confirmed CZS-associated microcephaly. The research protocol consisted of obtaining clinical history, laboratory tests, lower and upper urinary tract ultrasounds, as well as a diagnostic urodynamic evaluation. ZIKA virus infection was previously confirmed by maternal history and positive PCR in babies and mothers. Microcephaly and other central nervous system abnormalities were established based on neurological assessment and associated imaging of the central nervous system (CT head and/or Brain MRI). Results Twenty-two consecutive CZS patients were tested and confirmed to have neurogenic bladder. Of the 22 patients assessed, 21 presented with an overactive bladder combined with reduced bladder capacity and elevated detrusor filling pressures. Clinically significant increases in postvoid residual (PVR) were confirmed in 40% of cases while a urinary tract infection (UTI) was identified in 23% of cases. Conclusion Neurogenic bladder, a known treatable health condition, was confirmed in 100% of patients tested in this study, most presenting with high-risk urodynamic patterns known to lead to renal damage when left untreated. Follow up studies are necessary to provide further insight onto long-term disease progression and to investigate the response to standard therapies for neurogenic bladder. Nonetheless, we emphasize the importance of proactive management of neurogenic bladder and prompt referral so as to help mitigate CZS disease burden for patients and their families.
Databáze: OpenAIRE
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