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 |
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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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