C Aparicio López | PubMed Health

PubMed2001

[Vesical uric acid lithiasis in a child with renal hypouricemia].

We report a 12-month-old boy with renal hypouricemia who presented with crying due to obstructing vesicourethral uric acid stones. Metabolic study revealed persistent acidic urine with normal blood pH, and hypouricemia (1.4-1.7 mg/dl) with an increased ratio of uric acid clearance to creatinine clearance (24-32 %). Pyrazinamide produced no response but the patient showed a positive response to benzbromarone. These findings were consistent with a presecretory defect. No other tubular dysfunctions, such as renal glycosuria, aminoaciduria or phosphaturia were found. The patient underwent surgical treatment and was subsequently treated with potassium citrate. After a 2-year follow-up, he remains asymptomatic, despite persistent hyperuricosuria. To our knowledge, this is the youngest reported case of renal hypouricemia and lithiasis.

Humans↗

PubMed1999

[Metabolic changes in critically ill children].

OBJECTIVE: Our aim was to analyze the incidence of metabolic disturbances in critically ill children and to evaluate their correlation with severity of illness, complications, mortality and length of hospital stay. PATIENTS AND METHODS: We retrospectively studied 360 children who were admitted into a Pediatric Intensive Care Unit (PICU) between January 1995 and May 1996. We analyzed age, sex, initial diagnosis, complications, length of hospital stay and initial and final concentrations of serum glucose, calcium, phosphorus, magnesium and alkaline phosphatase. RESULTS: The incidence of different metabolic disturbances at admission to the PICU was: hyperglycemia 51.9%, hypoglycemia 1.9%, hypocalcemia 24.5%, hypercalcemia 5.8%, hyperphosphatemia 7.3%, hypophosphatemia 7.9%, hypomagnesemia 47.4% and hypermagnesemia 3%. Patients with shock had lower concentrations of calcium and higher phosphorus levels, while children with sepsis had lower magnesium concentrations. Patients who died had a higher incidence of hyperphosphatemia and higher values of serum glucose and magnesium at admission, while patients who survived had lower concentrations of calcium and higher incidence of hypomagnesemia. We did not find any correlation between the initial values for metabolites and length of stay in the PICU. CONCLUSIONS: Metabolic disturbances in critically ill children are frequent findings, correlate with important complications and can be prognostic markers. Thus, regular controls of different metabolites must be performed so we can precociously detect these disturbances and correct them.

Adolescent↗