病例报告:伴有近端肾小管损伤的儿童多系统炎症综合征。

Frontiers in nephrology Pub Date : 2023-06-19 eCollection Date: 2023-01-01 DOI:10.3389/fneph.2023.1194989
Silvia Maria Orsi, Carlotta Pepino, Lisa Rossoni, Margherita Serafino, Roberta Caorsi, Stefano Volpi, Serena Palmieri, Alessandro Faragli, Francesca Lugani, Carolina Bigatti, Gian Marco Ghiggeri, Enrico Eugenio Verrina, Edoardo La Porta, Andrea Angeletti
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引用次数: 0

摘要

导言儿童感染 SARS-CoV-2 后,可出现多器官炎症综合征,称为儿童多系统炎症综合征(MIS-C)。肾脏可受到多种可能的损伤,其发病机制尚不清楚:病例报告:我们报告了一例因 MIS-C 而严重累及心脏的 5 岁男孩的病例。住院两周后,腹部超声波检查显示膀胱内有大量 "碎片",随后出现血糖正常的糖尿。随着时间的推移,糖尿逐渐增多,尿沉渣中出现了无定形磷酸盐结晶。再加上低尿酸血症、尿酸增高和尿氨基酸全面增高,肾近曲小管损伤伴继发性范康尼样综合征的临床表现逐渐形成:本病例报告描述了一例 MIS-C 患者,该患者心脏和肾脏受累,以肾小管近端损伤为特征,病情改善缓慢,但随访 8 个月后仍持续存在。损害的发病机制尚不清楚,可能是多因素造成的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Case Report: Multisystem inflammatory syndrome in children with associated proximal tubular injury.

Case Report: Multisystem inflammatory syndrome in children with associated proximal tubular injury.

Case Report: Multisystem inflammatory syndrome in children with associated proximal tubular injury.

Introduction: SARS-CoV-2 infection in the pediatric population can be associated with a multiorgan inflammatory syndrome called children's multisystem inflammatory syndrome (MIS-C). The kidneys can be affected by a broad spectrum of possible injuries, whose pathogenetic mechanisms are still unclear.Case report: We report the case of a 5-year-old boy with severe cardiac involvement in the context of MIS-C. After two weeks of hospitalization, an abdominal ultrasound showed massive bladder "debris", followed by the onset of normoglycemic glycosuria. Over time, there was a progressive increase in glycosuria, and the presence of a mat of amorphous phosphate crystals was evidenced on urinary sediment. Together with the findings of hypo-uricemia, increased urinary uric acid, and globally increased urinary amino acids, a clinical picture of kidney proximal tubular damage with secondary Fanconi-like syndrome took shape.

Discussion: This case report describes the case of a patient with MIS-C with cardiac and kidney involvement characterized by proximal tubular damage, which slowly improved but still persisted at the 8-month follow-up. The pathogenesis of the damage is unclear and probably multifactorial.

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