Reversible renal medullary hyperechogenicity in neonatal hypernatremic dehydration
| Autor: | Shailendra Deshpande, Uma Ali, Aashish Chawla, Sandeep Saraf, Parmanand Andankar, Kalpana Sengupta |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urine Bartter syndrome Lethargy chemistry.chemical_compound Distal renal tubular acidosis Internal medicine Renal medulla medicine Humans Ultrasonography Kidney Medulla Creatinine Hypernatremia Dehydration business.industry Infant Newborn medicine.disease medicine.anatomical_structure Endocrinology chemistry Pediatrics Perinatology and Child Health Female Nephrocalcinosis business |
| Zdroj: | Pediatric Nephrology. 19 |
| ISSN: | 1432-198X 0931-041X |
| Popis: | Three exclusively breastfed term neonates were admitted with lethargy, poor feeding, and oligoanuria. All three babies were severely dehydrated and had a weight loss ranging from 18% to 40%. Serum sodium of more than 180 mEq/l and renal failure were observed in all three. Two had very high creatinine levels of 9.5 mg/dl and 6.7 mg/dl. Both these babies also had multiple seizures. One baby required mechanical ventilation. All three babies showed markedly hyperechoic renal medullary pyramids with speckled foci suggestive of crystal deposition that reversed completely on therapy. Urine showed abundant urate crystals in two and an elevated calcium/creatinine ratio of 1.6 in one. There was no evidence of distal renal tubular acidosis, Bartter syndrome, or high serum calcium. Supersaturation of the ions in a markedly hypertonic renal medulla may have led to crystallization, with resolubilization with hydration and restoration of good urine output. The hypernatremic dehydration was primarily due to lactation failure leading to inadequate fluid intake in the face of ongoing insensible losses. High breast milk sodium may have been a contributory factor in one patient. |
| Databáze: | OpenAIRE |
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