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EZEL ÇELAKIL M, AKTAŞ ÖZGÜR M, BEK K. Agenezi veya Multikistik Displazi: Doğuştan Tek Böbrekli Çocuklarda Hangisi Daha Kötü? KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.30934/kusbed.643654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kara A, Gurgoze MK, Aydin M, Koc ZP. Clinical features of children with multicystic dysplastic kidney. Pediatr Int 2018; 60:750-754. [PMID: 29856512 DOI: 10.1111/ped.13612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 05/11/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND To evaluate the clinical features of patients with multicystic dysplastic kidney (MCDK). METHODS The medical files of children diagnosed with MCDK between January 2008 and November 2015 were retrospectively reviewed. The demographic, clinical, laboratory and radiological data were evaluated. RESULTS Of 128 children with MCDK enrolled in the study, 82 (64.1%) were male, and 46 (35.9%) were female (P < 0.05). MCDK were located on left and right sides in 66 (51.6%) and 62 children (48.4%), respectively (P > 0.05). Antenatal diagnosis was present in 64 patients (50%). The mean age at diagnosis was 2.8 ± 2.7 years (range, 0-8 years), and follow-up duration was 4.5 years. Fifteen patients (20.8%) had vesicoureteral reflux. Of these, four underwent endoscopic surgical correction. Other associated urological anomalies were ureteropelvic junction obstruction (n = 6), hypospadias (n = 1), and kidney stones (n = 1). On technetium-99 m dimercaptosuccinic acid scintigraphy, which was performed in all patients, no significant association between grade of reflux and presence of scarring was seen. Hypertension was diagnosed only in one child (0.8%) who required antihypertensive treatment. The prevalence of unilateral undescended testicle in children aged <1 year in the 82 male patients was 4.9%. Seventy-six patients (59.4%) developed compensatory hypertrophy in the contralateral kidney during a 1 year follow-up period. Of the total, only seven children (5.5%) had undergone nephrectomy. CONCLUSIONS MCDK follows a benign course with relatively few sequelae, and therefore these patients should be closely followed up and conservatively managed.
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Affiliation(s)
- Aslihan Kara
- Department of Pediatric Nephrology, Firat University School of Medicine, Elazig, Turkey
| | - Metin Kaya Gurgoze
- Department of Pediatric Nephrology, Firat University School of Medicine, Elazig, Turkey
| | - Mustafa Aydin
- Department of Neonatology, Firat University School of Medicine, Elazig, Turkey
| | - Zehra Pinar Koc
- Department of Nuclear Medicine, Firat University School of Medicine, Elazig, Turkey
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Abstract
PURPOSE Neonatal renal cystic diseases have a great impact on the morbidity and mortality of the affected neonates and infants. A good insight into the pathophysiology, diagnosis and treatment options of various neonatal renal cystic diseases aid in early diagnosis and intervention, thereby preventing complications. METHODS PubMed search was done for articles on "neonatal renal cystic diseases" and relevant publications including reviews were considered for our article. RESULTS Both hereditary and nonhereditary causes of cystic kidney diseases can result in severe morbidity and mortality. The main diagnostic modality is ultrasound imaging and most of the neonatal renal cystic diseases are detected during prenatal ultrasound screening. Commonly encountered neonatal renal cystic diseases are autosomal dominant polycystic kidney disease, autosomal recessive polycystic kidney disease and multicystic dysplastic kidney. CONCLUSIONS A thorough knowledge of various renal cystic diseases can be of extreme prognostic value. Physicians should be aware of the impact of early diagnosis and intervention on the lives of those affected. Further research about treatment of these diseases is ongoing and can result in breakthrough therapies for these patients.
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Affiliation(s)
- Anshika Khare
- a Department of Internal Medicine , Northeast Ohio Medical University , Rootstown , OH , USA
| | - Vinod Krishnappa
- b Cleveland Clinic Akron General/Akron Nephrology Associates , Akron , OH , USA
| | - Deepak Kumar
- c Department of Pediatrics (Neonatology) , Metro Health Medical Center/Case Western Reserve University , Cleveland , OH , USA
| | - Rupesh Raina
- d Department of Nephrology, Cleveland Clinic Akron General and Akron Children's Hospital , Akron , OH , USA
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Dimala CA, Bechem NN, Kadia BM, Feteh VF, Choukem SP. Diagnostic and therapeutic challenges of an ambiguous cystic kidney disease in a resource limited setting: a case report. BMC Res Notes 2017; 10:114. [PMID: 28249589 PMCID: PMC5333378 DOI: 10.1186/s13104-017-2437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 02/24/2017] [Indexed: 12/03/2022] Open
Abstract
Background Unilateral renal cystic disease is a rare condition that shares morphological similarities with multicystic dysplastic kidney, the former often distinguished from the latter on some clinical and histopathological grounds. However serious diagnostic and therapeutic dilemmas set in when there is a considerable overlap in the distinguishing features between these entities. Case presentation A 19-year-old African female presented with a chronic severe debilitating right lower quadrant abdominal pain refractory to analgesics. Biochemical investigations and imaging studies revealed a non-functional polycystic right kidney and no identifiable pelvicalyceal system or ureter but with preserved renal function. The marked overlap in clinical presentation between unilateral renal cystic disease and multicystic dysplastic kidney in this patient necessitated further investigation to pose an appropriate diagnosis. A right nephrectomy was performed and histopathological analysis of the resected kidney done, the results of which were more consistent with unilateral renal cystic disease. The post-operative course was favorable. Conclusion Unilateral renal cystic disease with an ipsilateral non-functional kidney and an atretic pelvicalyceal system is a very rare condition that needs to be distinguished from multicystic dysplastic kidney in order to guide management and set prognosis. A suspicion of either of these diseases therefore warrants a thorough clinical evaluation and the appropriate combination of biochemical and imaging investigations.
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Affiliation(s)
- Christian Akem Dimala
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. .,Orthopaedics Department, Southend University Hospital, Essex, UK. .,Health and Human Development (2HD) Research Group, Douala, Cameroon.
| | | | | | - Vitalis Fambombi Feteh
- Health and Human Development (2HD) Research Group, Douala, Cameroon.,Mboppi Baptist Hospital, Douala, Cameroon
| | - Simeon Pierre Choukem
- Health and Human Development (2HD) Research Group, Douala, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Douala General Hospital, Douala, Cameroon
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Kumar M, Gathwala G, Ratttan KN, Lather S, Dalal P. Congenital Giant Dysplastic Kidney Presenting as Respiratory Distress: A Case Report. J Neonatal Surg 2017; 6:15. [PMID: 28083501 PMCID: PMC5224748 DOI: 10.21699/jns.v6i1.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 10/10/2016] [Indexed: 11/14/2022] Open
Abstract
Multicystic dysplastic kidney (MCDK) is the most common form of renal cystic disease in children and is one of the most common causes of abdominal mass in infancy. Here in we are reporting a rare case of a large MCKD that caused respiratory compromise and the infant presented with respiratory distress.
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Affiliation(s)
- Mahesh Kumar
- Neonatal Services Unit, Department of Pediatrics PGIMS, Rohtak
| | - Geeta Gathwala
- Neonatal Services Unit, Department of Pediatrics PGIMS, Rohtak
| | - K N Ratttan
- Department of Pediatric Surgery, PGIMS Rohtak
| | - Sandeep Lather
- Neonatal Services Unit, Department of Pediatrics PGIMS, Rohtak
| | - Poonam Dalal
- Neonatal Services Unit, Department of Pediatrics PGIMS, Rohtak
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Abstract
This article provides an up-to-date comprehensive review and summary on neonatal polycystic kidney disease (PKD) with emphasis on the differential diagnosis, clinical manifestations, diagnostic techniques, and potential therapeutic approaches for the major causes of neonatal PKD, namely hereditary disease, including autosomal recessive and autosomal dominant PKD and nonhereditary PKD, with particular emphasis on multicystic dysplastic kidney. A brief overview of obstructive cystic dysplasia and simple and complex cysts is also included.
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Alam K, Varshney M, Aziz M, Maheshwari V, Basha M, Gaur K, Ghani I. Multicystic renal dysplasia: a diagnostic dilemma. BMJ Case Rep 2011; 2011:bcr.03.2011.3989. [PMID: 22696732 DOI: 10.1136/bcr.03.2011.3989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 3-year-old male child had left-sided abdominal lump for 4 months. Radiological examination revealed a cystic mass in the left kidney. A tentative diagnosis of multicystic nephroma was made on clinical and radiological examination. Cytology was inconclusive. Nephrectomy was done. A final diagnosis of multicystic dysplasia was made on histological examination.
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Affiliation(s)
- Kiran Alam
- Department of Pathology, JN Medical College, Aligarh, India
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Cui Y, Eom M, Jung SH, Kim KJ, Jung WH. Malignant rhabdoid tumor of the kidney combined with multicystic dysplasia in a 5-year-old child. J Korean Med Sci 2010; 25:785-9. [PMID: 20436719 PMCID: PMC2858842 DOI: 10.3346/jkms.2010.25.5.785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Accepted: 01/22/2009] [Indexed: 11/20/2022] Open
Abstract
Multicystic dysplastic kidney (MCDK) is a relatively common developmental anomaly in infants and children and has a good prognosis. In contrast, a malignant rhabdoid tumor of the kidney (MRTK) is one of the most lethal neoplasms of early life. However, the presentation of such a lethal tumor combined with multicystic dysplasia has not been reported to date. In this report, we describe a case of MRTK in a 5-yr-old girl who also had multicystic dysplasia. She was previously diagnosed with MCDK at birth due to a huge palpable mass on the right side of the abdomen. The right kidney was extensively replaced by numerous grossly dilated, variable-sized cysts. Microscopically, the tumor cells show a diffusely infiltrative growth pattern, which revealed large non-cohesive, round-to-polygonal tumor cells with vesicular nuclei. Some tumor cells had eccentric nuclei and large, round, eosinophilic cytoplasmic inclusions. There were metanephrons present, with the central ureteric bud and peripheral branches surrounded by condensing mesenchyma, immature glomeruli, and metaplastic cartilage in the adjacent parenchyma. To our knowledge, this is the first combined case of the two aforementioned diseases and this case may, in fact, suggest a new disease entity.
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Affiliation(s)
- Ying Cui
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Minseob Eom
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soon-Hee Jung
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kwang Jin Kim
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Woo Hee Jung
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
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Aubertin G, Cripps S, Coleman G, McGillivray B, Yong SL, Van Allen M, Shaw D, Arbour L. Prenatal diagnosis of apparently isolated unilateral multicystic kidney: implications for counselling and management. Prenat Diagn 2002; 22:388-94. [PMID: 12001193 DOI: 10.1002/pd.319] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cases where initial prenatal diagnosis was made of isolated unilateral multicystic kidney (UMCK) were reviewed to determine appropriate counselling and management strategies. For the 73 cases, chromosome abnormalities, pregnancy complications and family histories were reviewed. In addition, subsequently diagnosed birth defects, and pediatric medical and surgical outcomes were available for 54 cases. Of those with outcome information available renal/genital-urinary tract abnormalities were diagnosed subsequently in 33% and non-renal abnormalities in 16% of cases. Of the non-renal abnormalities, congenital heart defects were most frequent (7%). One chromosome abnormality, a trisomy 21, was present among 32 cases where karyotypes were known (3%). Amniotic fluid volume abnormalities were present in 11 cases but not predictive of associated anomalies, with the exception of one case where polyhydramnios accompanied multiple malformations consistent with VATER association. A family history of structural renal anomalies was reported in 11 cases (20%). There were 14 cases of partial or complete involution (25%), including two cases of complete prenatal involution of the cystic kidneys. No long-term associated morbidity such as hypertension or malignancy was present in our cohort. Based on our study and corroborating literature, amniocentesis should be offered to women when a seemingly isolated UMCK is detected on routine prenatal ultrasound. Furthermore, a detailed ultrasound with careful assessment of the fetal heart and contralateral kidney is indicated at diagnosis and during the third trimester to assess for further evidence of structural abnormalities, as well as amniotic fluid volume abnormalities. Careful assessment of the newborn is indicated with appropriate speciality referral as required.
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Affiliation(s)
- G Aubertin
- Department of Medical Genetics, University of British Columbia, British Columbia's Children's and Women's Hospital, Vancouver, Canada
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Robson WL, Leung AK. Scarring is the central issue in urinary tract infection, not vesicoureteral reflux. Clin Pediatr (Phila) 2001; 40:302-3. [PMID: 11388684 DOI: 10.1177/000992280104000516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- D A Husmann
- Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Robson WL, Thomason MA, Minette LJ. Cystic dysplasia of the testis associated with multicystic dysplasia of the kidney. Urology 1998; 51:477-9. [PMID: 9510356 DOI: 10.1016/s0090-4295(97)00688-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A child with cystic dysplasia of the testis (CDT) that presented as a solid mass by ultrasound imaging is reported. The child also had ipsilateral multicystic dysplasia of the kidney (MCDK). A search of the literature revealed that unilateral renal agenesis (URA) is commonly associated with CDT. It is possible that CDT, MCDK, and URA share a common pathogenesis. Cystic changes in the epididymis were found in the patient and might be more frequently associated with CDT than previously reported. CDT should be considered in the differential diagnosis of a solid testicular mass detected by ultrasound.
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Affiliation(s)
- W L Robson
- Department of Pediatrics, Children's Hospital, Greenville, South Carolina 29605-4253, USA
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