UROLITHIASIS IN CHILDREN Presenting Signs, Etiology, Bacteriology and Localisation

Abstract

Based on a personal series of 310 observations, the authors have studied the presenting signs, the etiology, the urinary bacteriology and the localization of the stone in children with urolithiasis. Urinary tract infection is the presenting sign in 55% of the cases, hematuria in 23% and abdominal pain in 20%. Urinary malformation is associated in 26% of cases, whatever the age at diagnosis. The urinary bacteria found in 55% of cases is Proteus. Localization was in the kidney in 228 cases, in the ureter in 71 cases, the bladder in 45 cases and in the urethra in 5 cases.

Urolithiasis in infants

“…The UNI represents 20% of the sum total of pediatric lithiases in the literature [1][2][3]. A clear masculine preponderance is observed among infants.…”

Renal stone disease--investigative aspects.

“…4 Cystinuria is a consequence of defective renal reabsorption of basic amino acids resulting in urinary concentrations of cystine that exceed its solubility. However not all individuals with the defect form stones, and not all the stones formed are pure cystine.…”

“…However not all individuals with the defect form stones, and not all the stones formed are pure cystine. 4 Urate crystaluria and occasionally urolithiasis may be a complication ofhaematological tumours after chemotherapy. Hyperuricaemia may also be caused by a deficient activity of the enzyme hypoxanthine-guanine phosphoribosyl transferase (HGPRT).…”

“…The presence of typical cystine crystals is specific to cystinuria, but they are observed in only 20% of cystinurics. 4 There is at present no clinical value in measuring the urinary excretion of stone inhibitors. Although there is scientific evidence linking a decrease in their excretion or an imbalance to an enhanced tendency to form stones, there is little evidence yet that therapeutic intervention is of benefit.…”

“…The disease is more prevalent in less industrialised countries where a high proportion of bladder stones are found.2 Most patients present in the early years of childhood,3 usually with a urinary tract infection, abdominal pain, or haematuria. 4 Although the majority have only one episode of stone formation,5 it is important to identify risk factors wherever possible because specific treatments can reduce stone recurrence and renal damage in those most at risk. 6 7 Aetiology Renal stones result from the precipitation and growth of crystals within the urinary tract.…”