Features of pyelonephritis course in adolescent females with co-existing anаemic syndrome

I.S. Lembryk, I.V. Shlimkevych, A.B. Stefanyshyn, O.V. Zhyliak, N.I. Kostyrko
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Abstract

Background. Anaemic syndrome of complex origin is not uncommon in urinary tract infection, particularly in dietary non-adherence, menstrual cycle disorders, or concomitant digestive diseases, recurrent respiratory infections, etc. However, there is currently insufficient epidemiological data on this comorbidity in the literature. This study aims to establish the features of pyelonephritis course in its combination with anaemic syndrome in children. Materials and methods. We analysed the medical records of 200 children aged 0 to 17 years with acute non-complicated pyelonephritis, complicated and recurrent urinary tract infections for 2012–2017. In the second stage of our work, we comprehensively examined 85 girls aged 11 to 17 who underwent inpatient treatment between 2018 and March 2023. Thirty children of the same age and gender made up the comparison group. A paediatric gastroenterologist, a paediatric gynaecologist and/or urologist examined all patients. Immunochemical method with electrochemiluminescence immunoassay was used to assess ferritin content; also, serum iron and total iron-binding capacity were measured. Results. Anaemic syndrome is common in most girls with urinary tract infections (58.8 % of сases). Among the causes, the follo­wing are distinguished: menstrual cycle disorders with abnormal uterine bleeding (50.0 %), chronic digestive disorders, in particular malabsorption syndrome of unknown origin (25.0 %), recurrent bronchopulmonary disorders (15.0 %), and unbalanced diet (10.0 %). The features of urinary tract infections and concomitant iron deficiency in children include fatigue (55.0 % in acute non-complicated pyelonephritis vs. 40.0 % in complicated urinary tract infections, р < 0.05), dizziness (35.0 % in acute non-complica­ted pyelonephritis vs. 15.0 % in recurrent urinary tract infections, χ2 = 48.6532, р < 0.05), and pallor (25.0 % in complicated urinary tract infections vs. 10 % in recurrent urinary tract infections, χ2 = 0.7168, р > 0.05). The ferritin level was the highest in patients with complicated urinary tract infections (18.2 µg/mL). In patients with recurrent urinary tract infections, this indicator was the lo­west — 5.0 µg/mL. Conclusions. Retrospective analysis of medical records confirmed the presence of anaemia in 30.0 % of girls with inflammatory kidney diseases. During the physical examination, 58.8 % of female adolescents with urinary tract infections had signs of anaemic syndrome.
并发贫血综合征的青春期女性肾盂肾炎病程特点
背景。起因复杂的贫血综合征在尿路感染中并不少见,特别是在饮食不遵守、月经周期紊乱、或伴有消化系统疾病、反复呼吸道感染等情况下。然而,目前文献中关于这种合并症的流行病学数据不足。本研究旨在探讨小儿肾盂肾炎合并贫血综合征的病程特点。材料和方法。我们分析了2012-2017年200例0 - 17岁急性非并发症肾盂肾炎、并发症和复发性尿路感染患儿的医疗记录。在我们工作的第二阶段,我们全面检查了85名11至17岁的女孩,她们在2018年至2023年3月期间接受了住院治疗。30名年龄和性别相同的儿童组成了对照组。一名儿科胃肠科医生、一名儿科妇科医生和/或泌尿科医生检查了所有患者。采用免疫化学法和电化学发光免疫分析法测定铁蛋白含量;测定血清铁和总铁结合能力。结果。贫血综合征常见于大多数泌尿道感染的女孩(58.8%的病例)。在病因中,可区分如下:月经周期紊乱伴子宫异常出血(50.0%)、慢性消化系统紊乱,特别是不明原因的吸收不良综合征(25.0%)、复发性支气管肺紊乱(15.0%)和饮食不平衡(10.0%)。儿童尿路感染伴铁缺乏的特征包括疲劳(急性非并发症肾盂肾炎55.0%,并发症尿路感染40.0%);急性无并发症肾盂肾炎组为35.0%,复发性尿路感染组为15.0%,χ2 = 48.6532, p < 0.05);并发性尿路感染25.0%,复发性尿路感染10%,χ2 = 0.7168, p < 0.05);0.05)。并发尿路感染患者铁蛋白水平最高(18.2µg/mL)。对于复发性尿路感染患者,该指标为最低- 5.0µg/mL。结论。对医疗记录的回顾性分析证实,患有炎症性肾病的女孩中有30.0%存在贫血。在体检中,58.8%的女性青少年尿路感染患者有贫血综合征征象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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