پانل نفرولوژی کودکان

در این پنل مواجه علمی با 6 بیمار با شما به بحث گذاشته خواهد شد که شامل موارد زیر است:

Case1:

•A 6 months old female infant was admitted due to fever and irritability for 4 days.
U/A: 2+ protein, WBC=8-10, RBC=6-8 and U/C with bag was sent and ceftriaxone started. After 24 hr. U/C>100000 colonies mixed
growth.
KUB Sono: left sided increased renal echo and caliectasis...................................

Case2:

•A 24 months old girl wad admitted with fever
and diarrhea for 10 days.
• U/A: 6-8 WBC, moderate bacteria.
• ESR=37, CRP=2+
• The first dose of antibiotic was started before U/C sampling.
• U/C was negative after 24 hours....................................

Case3:

•A 24 months old girl with documented febrile UTI one year ago, referred with fever and irritability for 24 hours and U/A showed 8-10 WBC.
• After urine sample for culture cefixime was started and after 24 hours it was discontinued due to negative U/C. Fever was discontinued 24 hours later......................................

Case4:

• A 16 months old infant with fever and cough for 2 days.
• U/A: Normal, ESR=55,CRP=64, WBC=3100
• Fever was discontinued after 24 hours without antibiotic therapy..................................

Case5:

• A 13 months old infant presented with fever and convulsion. U/A: nitrite 2+, moderate bacreia. ESR=17, CRP=2, U/C>100000 colonies of E.Coli, resistant to ceftriaxone.
• LP was failed.
• Sono or U/C during treatment was not done.
• Ceftriaxone was used for 5 days, fever discontinued.......................................

Case6:A previously healthy 9-year-old boy reported 3 episodes of painless passage of red colored urine, occurring immediately after exercise and lasting for 2 or 3 urinations. No fever or other symptoms were reported. The family history was negative for kidney disease and hematological disorders. physical examination revealed no pathological signs.

The CBC, levels of serum electrolytes and creatinine, and liver function tests were all within the normal range.

serum complement C3 and C4 were in the lower normal range (C3 84 mg/dl, normal range 83–177 mg/dl, and C4 15 mg/dl, normal range 15–45 mg/dl). The antistreptolysin O antibodies (ASTO) titer was 613 IU/ml (normal < 200 IU/ml), and throat swab culture was positive for group A β-hemolytic Streptococcus,

Urinalysis revealed density 1.015, pH 6, negative albumin, hemoglobin +++, and erythrocytes 80–100 cells/hpf.

24 hour urine collection revealed calcium excretion 5 mg/kg/d and total protein excretion 84 mg/m2 /d,

and urine culture was negative. Urinary tract ultrasound was normal.

He was hospitalized for 4 days, during which time no further episode of macroscopic hematuria occurred. Urinalysis  and 24 h urine calcium and protein on discharge was normal......................

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