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Stenosing ureteritis in a 7-year-old boy with Henoch-Schönlein purpura nephritis: A case report and review of the literature.
MedLine Citation:
PMID:  20382571     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Urinary tract obstruction resulting from Henoch-Schönlein purpura (HSP) is an extremely rare urologic entity. If the genitourinary system is involved, it is primarily in the form of a focal proliferative glomerulonephritis. Stenosing disease has received little attention in the literature and treatment options are limited. Despite early intervention renal loss may be inevitable.
CASE REPORT: A 7-year-old African American male presented with renal failure secondary to bilateral sclerosing ureteritis 1 month after initial presentation with HSP. There was significant disease progression and he required multiple procedures, ultimately bilateral ureterocalycostomies and a left nephrectomy.
DISCUSSION: HSP is an immune-mediated necrotizing vasculitis. It can affect any organ system; however, in the genitourinary system, focal proliferative glomerulonephritis is a common manifestation, occurring in 20-90% of cases [8]. Extrarenal manifestations are rare.
CONCLUSION: Ureteritis and obstruction may be late occurrences, but should be considered in all patients presenting with a history of HSP and new-onset flank pain, acute renal failure, or anuria. Families and patients should be counseled that renal impairment may be a consequence of stenosing ureteritis. Management of these patients can be complicated but surgical correction must be considered in the treatment algorithm once the disease has stabilized.
Authors:
Sean T Corbett; Jennifer N Lennington; Annabelle N Chua; Edmond T Gonzales
Publication Detail:
Type:  Journal Article     Date:  2010-04-10
Journal Detail:
Title:  Journal of pediatric urology     Volume:  6     ISSN:  1873-4898     ISO Abbreviation:  J Pediatr Urol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  538-42     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. stc2u@virginia.edu
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