Biomedical subjects
Publications and source records attributed to S A al Rasheed.
The clinical biochemical, radiological, and histological data of a 5-year-old boy with severe limb deformities and renal failure due to oligomeganephronia and renal hypoplasia are reported. This patient represents another example of acrorenal syndrome. This boy has a severe visual defect due to pigmentory retinopathy, which has not been reported previously.
Osteopetrosis is commonly associated with short stature. To identify the cause, 8 children with osteopetrosis and short stature were studied. One showed evidence of renal tubular acidosis, none showed evidence of anaemia, and all were clinically and biochemically euthyroid. Growth hormone profile was assessed using night sampling (8 patients), growth hormone provocative testing using insulin-induced hypoglycaemia (6 patients), and L-dopa-propranolol (8 patients). The mean nocturnal growth hormone values taken at 60 and 90 min after onset of sleep and at 4 a.m. were 5.5, 12.8, and 11.5 mu/L respectively. The peak stimulated growth hormone mean values with the insulin-induced hypoglycaemia (glucose 1.6-3.0 mmol/L, mean = 2.2) was 14 mu/L (range 7.3-24.5 mu/L) and with the L-dopa-propranolol was 25.6 mu/L (range 12.3-49 mu/L). IGF1 levels taken at 0 and 120 min of insulin-induced hypoglycaemia (0 min for L-dopa-propranolol), and at 120 min of L-dopa-propranolol, showed normal values for age. We conclude that: (1) growth hormone profiles in these children are normal; (2) tissue unresponsiveness to growth hormone and/or IGF1 is not likely to be the cause of short stature in children with osteopetrosis; and (3) osteopetrosis per se is not an indication for assessment of growth hormone status.
A retrospective study of 42 children with 45 proven urinary tract stones who had had intravenous urography (IVU), ultrasound examination and a plain abdominal X-ray (KUB) was undertaken in order to evaluate the prediction rate of each method. Ultrasound was more sensitive than KUB (91% vs 80%) in detecting stones. All renal stones were detected by ultrasound. KUB was superior to ultrasound in detecting ureteral stones (66.6% vs 55.5%). All stones were detected by the combination of ultrasound and KUB. Two renal radiolucent stones were missed by IVU. The results of this study suggest that the combination of ultrasound examination and KUB is more sensitive in detecting stones than IVU and is more convenient and less invasive.
A 1.5-year-old Saudi girl with hemolytic uremic syndrome is described. She developed hyperglycemia in the acute stage which required insulin therapy. After a short remission, she developed permanent insulin-dependent diabetes mellitus. Review of the literature of the occurrence and the pathophysiology of this phenomenon is presented.
A retrospective study was carried out on 40 children from Saudi Arabia with Henoch-Schönlein syndrome to delineate its clinical pattern. More than 50 per cent of the cases occurred in winter. There was no apparent causal relationship with B-haemolytic streptococcal infection. All patients had skin rash. Fifty-eight per cent had gastrointestinal manifestations, 58 per cent had joint manifestations and 38 per cent had renal manifestations. The main clinical features of Henoch-Schönlein syndrome in Saudi children are comparable to those reported elsewhere.
One hundred and twenty percutaneous renal biopsies performed in 104 patients aged 1 month to 15 years were analysed. Ultrasound examination was used for localization of the kidneys. Adequate renal tissue was obtained in 103 biopsies, with an overall success rate of 85.8%. The most frequent complication was gross haematuria, which occurred in 32 biopsies, but only 5 children required blood transfusion. Nineteen patients developed perirenal haematoma; 2 of these were symptomatic. Arteriovenous fistula was diagnosed in 2 patients. One patient died secondary to intestinal perforation. Serious complications were noted in patients with chronic renal failure. The success and complication rates in 10 patients less than 1 year of age were comparable with the rest of the group. The frequency of serious complications on renal biopsy in the present study was slightly higher than in the more developed countries.