このエントリーをはてなブックマークに追加
ID 59903
著者
Miyahara, Hiroyuki Department of Pediatrics, Okayama University Hospital ORCID Kaken ID
Akiyama, Tomoyuki Department of Child Neurology, Okayama University Hospital Kaken ID researchmap
Hasegawa, Kosei Department of Pediatrics, Okayama University Hospital ORCID Kaken ID researchmap
Akiyama, Mari Department of Child Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine
Oka, Makio Department of Child Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine
Kobayashi, Katsuhiro Department of Child Neurology, Okayama University Hospital Kaken ID publons researchmap
Tsukahara, Hirokazu Department of Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Kaken ID publons researchmap
抄録
Background
Renal calcified lesions are known as one of the complications during adrenocorticotropic hormone (ACTH) therapy for intractable epilepsy. However, laboratory changes during the therapy or laboratory features of high‐risk cases with renal calcified lesions are yet to be clarified.
Methods
In this study, 43 patients with West syndrome aged ≤2 years were included. We retrospectively reviewed age and body mass index at the beginning of ACTH therapy, as well as the amount of fluid intake, daily urinary volume, and laboratory data during therapy. In addition, we studied the urinary sediment of the cases with renal calcified lesions diagnosed by computed tomography. Results After initiating ACTH treatment, urinary calcium (Ca)/creatinine ratio and urinary pH increased within 2 weeks. Urinary crystals and renal tubular epithelial cells (RTECs) in urinary sediment were frequently found in most cases. Urinary Ca levels, proteinuria or frequency of urinary crystals, and number of RTECs in the urinary sediment were significantly higher in patients with epithelial casts (ECs) or hematuria than in patients without these findings. Among the seven patients who underwent abdominal CT, ECs or hematuria were found only in those with renal calcified lesions. These findings suggested that patients with ECs or hematuria were more likely to have calcified lesions.
Conclusions
The risk of renal calcified lesions increased after 2 weeks of ACTH treatment. Abnormal findings in urinary sediments might be an early sign of renal calcification during ACTH therapy.
キーワード
adrenocorticotropic hormone therapy
calcium
crystal
renal tubular epithelial cell
urinary sediment
備考
This is the peer reviewed version of the following article: Miyahara, Hiroyuki et.al. "Laboratory changes during adrenocorticotropic hormone therapy associated with renal calcified lesions" Pediatrics International 62(5) 587-592 (2020), which has been published in final form at https://doi.org/10.1111/ped.14158. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
This fulltext is available in Jun. 2021.
発行日
2020-01-19
出版物タイトル
Pediatrics International
62巻
5号
出版者
Wiley
開始ページ
587
終了ページ
592
ISSN
1328-8067
NCID
AA11320483
資料タイプ
学術雑誌論文
言語
English
OAI-PMH Set
岡山大学
著作権者
© 2020 Japan Pediatric Society
論文のバージョン
author
PubMed ID
DOI
Web of Science KeyUT
関連URL
isVersionOf https://doi.org/10.1111/ped.14158