Transient generalized proximal tubular dysfunction in an infant with a urinary tract infection: the effect of maternal infliximab therapy?

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2021-01-01 DOI:10.1515/crpm-2020-0050

M. Schreuder, H. de Jong, E. C. van der Kuur, E. Cornelissen

引用次数: 1

Abstract

Abstract Objectives Urinary tract infections (UTIs) are common in childhood. Distal tubular dysfunction during a UTI is relatively common, but proximal tubular involvement is a unique feature in humans. Case presentation We present the first case of transient generalized proximal tubular dysfunction (renal Fanconi syndrome) in an infant with an UTI. During pregnancy, his mother was treated for Crohn’s disease with infliximab (last dose at 28 weeks of gestation). He presented at the age of six weeks with a reduced intake, and was found to have amino-aciduria, glucosuria, and urinary loss of potassium, bicarbonate and low-molecular-weight proteins. Within a few weeks after antibiotic treatment for the UTI, no proximal tubular disorder remained and the boy is doing well. Conclusions We hypothesize that the inflammatory response caused by the UTI was more profoundly present due to the maternal infliximab therapy, and thereby included not only the distal but also the proximal tubules.

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一过性全身性尿路感染婴儿近端小管功能障碍:母亲英夫利昔单抗治疗的效果?

摘要目的尿路感染是儿童期常见的疾病。尿路感染期间远端肾小管功能障碍相对常见，但近端肾小管受累是人类独有的特征。病例介绍:我们报告了一例婴幼儿尿路感染的暂时性全身性近端肾小管功能障碍(肾范可尼综合征)。在怀孕期间，他的母亲用英夫利昔单抗治疗克罗恩病(妊娠28周时最后一次给药)。他在6周大时出现摄入量减少，并发现有氨基酸尿症、糖尿症、尿中钾、碳酸氢盐和低分子量蛋白质的丢失。在对尿路感染进行抗生素治疗后的几周内，没有近端肾小管紊乱，男孩的情况很好。结论我们推测，由于母亲的英夫利昔单抗治疗，尿路感染引起的炎症反应更为深刻，因此不仅包括远端小管，也包括近端小管。

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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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.