关键词: 儿童, 结核,肾, 体征和症状, 疾病特征, 回顾性研究

Abstract:

Objective We analyzed the clinical characteristics of children with renal tuberculosis to provide clues for the early diagnosis of renal tuberculosis in children.Methods We retrospectively analyzed the clinical data on 14 cases who hospitalized and diagnosed with renal tuberculosis in Beijing Children’s Hospital, Capital Medical University and West China Second Hospital, Sichuan University between January 2009 and December 2014, including the general information, medical history, clinical manifestations, and imaging features.Results The median age of the 14 children was 9.5 (9.3, 12.7) years old. Three of them only had renal tuberculosis, ten were complicated with pulmonary tuberculosis and extrapulmonary tuberculosis, and the remaining one was complicated with pulmonary tuberculosis. The interval between onset of the diseases and hospitalization was 2.0 (1.0, 7.0) months. Before hospitalized in our hospitals, all 14 children were diagnosed and treated in local hospitals, five of who were diagnosed with pulmonary tuberculosis, two were diagnosed with extrapulmonary tuberculosis, two were diagnosed with renal tuberculosis, and the remaining five were diagnosed with other disease but not tuberculosis. The most common symptom was fever (11 cases), followed by signs of urethral irritation such as urinary frequency, urgency and pain (three cases), hematuria (three cases), percussed pain in kidney (two cases), and low back pain (one case). Acid fast stain positive results were observed in urine sample in one child, gastric samples in two children and sputum sample in one child. Urine routine examination showed that 5 cases had positive urine occult blood and 5 patients had positive urine protein. Among the 14 children, 11 performed renal B-ultrasound or pelvic angiography examination, and the imaging results showed renal parenchyma damage, hydronephrosis and ureteral expansion.Conclusion Renal tuberculosis in children lacks systemic symptoms, and was usually complicated with tuberculosis infection in other sites. The urinary symptoms are not common. Renal tuberculosis has a long latency period, leading to a delay in diagnosis. Imaging and laboratory examination are critical for early diagnosis of renal tuberculosis.

Key words: Child, Tuberculosis, renal, Signs and symptoms, Disease attributes, Retrospective studies