Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
Login Abbonamenti Pubblicazioni Carrello Registrazione Perché registrarsi? Contatti

Caso contributivo

PDF

Il sale della vita: esami di laboratorio nelle IVU?

The salt of life: blood test in urinary tract infection?

Giulia Bassanese, Stefania Norbedo, Marco Pennesi
Clinica Pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste

Maggio 2014

Abstract
Severe hyponatremia has been reported as a possible complication in children with renal dysplasia and urinary tract infection (UTI). The pathogenesis of this conditions is probably due to concomitant events such as renal parenchima flogosis and the immature tubuli function that may lead to a secondary pseudohypoaldosteronism. The paper reports a case of severe hyponatremia in a five-month-old infant with renal dysplasia and vesicoureteral reflux during a UTI episode. Even though Guidelines do not suggest performing lab tests in these children, the advice is monitoring their electrolytes to exclude severe hyponatremia complications such as pontine myelinolisis (also known as osmotic demyelination) that is a neurologic disorder following rapid correction of sodium defect.
Contenuto riservato

Per leggere l'articolo è necessario effettuare il login.

Bibliografia
Bülchmann G, Schuster T, Heger A, Kuhnle U, Joppich I, Schmidt H. Transient pseudohypoaldosteronism secondary to posterior urethral valves - a case report and review of the literature. Eur J Pediatr Surg 2001;11(4):277-9. Dunn K, Butt W. Extreme sodium derangement in a paediatric inpatient population. J Paediatr Child Health 1997;33:26-30. Holzinger A, Riepe FG, Krone N, Grasser M, Münch HG, Schwarz HP. Extreme hyponatremia in an infant with congenital adrenal hypoplasia due to a novel NR0B1 (DAX-1) mutation. Klin Padiatr 2008;220:287-90. Huppke P, Heise A, Rostasy K, Huppke B, Gärtner J. Immunoglobulin therapy in idiopathic hypothalamic dysfunction. Pediatr Neurol 2009;41:232-4. Jose SS, Sharif ES. New NICE guidelines for UTI management: what will change? Arch Dis Child 2008;93(8):716-7. Kliegman RM, Stanton BMD, Geme JS, Schor N, Behrman RE. Nelson Textbook of Pediatrics, 19th Edition. Expert Consult Premium Edition - Enhanced Online Features and Print. Saunders, 2011. Larcombe J. Urinary tract infection in children. Am Fam Physician 2010;82(10):1252-6. Montini G, Rigon L, Zucchetta P, et al.; IRIS Group. Prophylaxis after first febrile urinary tract infection in children? A multicenter, randomized, controlled, noninferiority trial. Pediatrics 2008;122:1064-71. Pumberger W, Frigo E, Geissler W. Transient pseudohypoaldosteronism in obstructive renal disease. Eur J Ped Surg 1998;8(3):174-7. Tullu MS, Deshmukh I, Muranjan MN, Kher AS, Lahiri KR. Extrapontine myelinolysis in a child with nephrotic syndrome. Pediatr Neurol 2010;43(2):139-41.