kidney anomaly

肾脏异常
  • 文章类型: Case Reports
    介绍1例马蹄肾和双侧鳞状细胞癌(SCC)患者,目前尚无报道。一名61岁的妇女出现腹部肿块和近期严重血尿。影像学检查提示右肾下肾及马鞋肾峡部恶性病变,中线向左侧。最后,患者接受了双侧完整根治性肾输尿管切除术,病理评估与双侧鳞状细胞癌相符。这是马蹄肾双侧SCC的第一份报告,该报告是通过开放的整体根治性肾切除术进行的。
    To present a patient with horseshoe kidney and bilateral squamous cell carcinoma (SCC) which has not been reported so far. A 61-year-old woman presented with abdominal mass and recent episodes of gross hematuria. Imaging revealed malignant lesion of lower calyces of the right kidney and isthmus of horse-shoe kidney with midline crossing to the left side. Finally, the patient underwent bilateral enbloc radical nephroureterectomy and pathology evaluation was compatible with bilateral squamous cell carcinoma. This is the first report of bilateral SCC in horseshoe kidney which was managed via open enbloc radical nephroureterectomy.
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  • 文章类型: Case Reports
    肾脏融合异常代表肾脏和泌尿道(CAKUT)的先天性异常的一部分。马蹄形肾脏(HSKs)是肾脏在其下部两极的融合。它是最常见的形式的CAKUT。症状通常很微妙。诊断通常是在儿童时期偶然做出的。HSK很少在以后的生活中出现症状。我们介绍了一名88岁的女性,有HSK病史,她到急诊科(ED)就诊,有三周的左侧腹部疼痛史,间歇性恶心,尿量减少.她的住院检查包括影像学检查显示HSK和双侧肾积水,左边更突出。在生命后期出现HSK症状极为罕见。
    Abnormalities in renal fusion represent a subset of congenital anomalies of the kidneys and urinary tract (CAKUT). Horseshoe kidneys (HSKs) are the fusion of kidneys at their lower poles. It is the most common form of CAKUT. Symptoms are usually subtle. The diagnosis is usually made incidentally during childhood. Rarely does an HSK become symptomatic later in life. We present the case of an 88-year-old female with a history of HSK who presented to the emergency department (ED) with a three-week history of left-sided flank pain, intermittent nausea, and reduced urine output. Her inpatient workup included imaging that revealed an HSK and bilateral hydronephrosis, which was more prominent on the left. The onset of symptoms for an HSK late in life is extremely rare.
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  • 文章类型: Case Reports
    交叉和非融合的肾脏是极为罕见的先天性异常,其中一个或两个肾脏越过中线到另一侧。同时,输尿管插入膀胱的正常解剖位置。尽管交叉异位肾脏大多无症状,并且在其他疾病的检查过程中偶然发现,他们容易发生泌尿系统并发症,如尿路感染(UTI)。在这里,我们介绍了一名12岁的男性,有复发性尿路感染和尿retention留的病史,他因复发性尿路感染和尿retention留到急诊科就诊,最终发现右腰区域有异位未融合的左肾计算机断层扫描(CT)。
    Crossed and non-fused kidneys are an exceedingly rare congenital anomaly in which one or both kidneys cross the midline to the opposite side. At the same time, the ureters are inserted in their normal anatomical locations in the bladder. Although crossed ectopic kidneys are mostly asymptomatic and incidentally discovered during workup for other disorders, they are prone to urological complications such as urinary tract infections (UTIs). Here we present the case of a 12-year-old male with a history of recurrent UTIs and urinary retention who presented to the emergency department with recurrent UTIs and urinary retention and was eventually found to have an ectopic unfused left kidney in the right lumbar region on computed tomography (CT).
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  • 文章类型: Journal Article
    本研究旨在评估拷贝数变异(CNV)与胎儿肾脏超声异常的关联。共纳入331例接受产前染色体微阵列分析的肾脏超声异常胎儿。根据肾脏异常的类型,将胎儿分为孤立和非孤立异常组。
    在3.4%或7.3%有孤立性或非孤立性肾脏异常的胎儿中发现有临床意义的CNV,分别。与肾实质畸形(4.7%)或泌尿系统异常(3.4%)的胎儿相比,在肾脏胚胎迁移异常的胎儿(6.6%)中发现CNV的频率更高。特别是,CNV在异位肾脏的胎儿中最常见(9.5%),但在马蹄形肾脏或孤立的双重肾脏的胎儿中未检测到。在这些CNVs中,最常见的是del(17)(q12q12)(1.2%)和del(22)(q11q11)(0.6%)。在本研究中鉴定了dup(17)(p12p12)和del(15)(q11.2q11.2)CNVs,但在以前的研究中未鉴定。del(X)(p11.4p11.4)和del(16)(p13.3p13.3)CNVs进一步与肾脏异常相关。
    肾脏(特别是异位肾脏)胚胎迁移异常的胎儿显示出更高的临床上有意义的CNVs,而具有马蹄形肾或双肾的胎儿与这些CNV的相关性较低。
    UNASSIGNED: This study aimed to estimate the associations of copy number variants (CNVs) with fetal kidney ultrasound anomalies. A total of 331 fetuses with kidney ultrasound anomalies who underwent prenatal chromosomal microarray analyses were enrolled. The fetuses were classified into groups with isolated and nonisolated anomalies or according to the types of kidney anomalies.
    UNASSIGNED: Clinically significant CNVs were identified in 3.4% or 7.3% of fetuses with isolated or nonisolated kidney anomalies, respectively. CNVs were more frequently identified in fetuses with abnormal embryonic migration of the kidneys (6.6%) than in fetuses with malformations of the renal parenchyma (4.7%) or anomalies of the urinary collecting system (3.4%). In particular, CNVs were most frequently detected in fetuses with ectopic kidneys (9.5%) but not in fetuses with horseshoe kidneys or isolated duplex kidneys. Among these CNVs, the most common were del(17)(q12q12) (1.2%) and del(22)(q11q11) (0.6%). The dup(17)(p12p12) and del(15)(q11.2q11.2) CNVs were identified in this study but not in previous studies. The del(X)(p11.4p11.4) and del(16)(p13.3p13.3) CNVs were further implicated as associated with kidney anomalies.
    UNASSIGNED: Fetuses with abnormal embryonic migration of the kidneys (particularly ectopic kidneys) showed a higher frequency of clinically significant CNVs, whereas fetuses with horseshoe kidneys or duplex kidneys were less frequently associated with these CNVs.
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  • 文章类型: Journal Article
    目的:将严重先天性畸形的研究限制在活产儿童中,可能会导致严重的偏倚。在这项研究中,我们估计了妊娠中期胎儿畸形筛查计划的出勤率.我们还估计了丹麦国家患者登记处(DNPR)中记录的产前分配的国际疾病10分类诊断的阳性预测值(PPV)以及病例登记的完整性。我们以肾脏异常为例。
    方法:我们确定了2007年1月1日至2012年12月31日所有丹麦活产婴儿的比例,这些婴儿在孕中期使用DNPR和民事登记系统进行扫描。根据DNPR检索具有特定肾脏异常诊断的所有胎儿的详细信息。PPV是使用全国的Astrica怀孕医疗图表或传统医疗图表数据库估算的,作为黄金标准。使用通过捕获-重新捕获方法估计的病例总数来评估完整性。
    结果:在372,263名活产婴儿中,在妊娠中期扫描了97.3%。我们在DNPR中鉴定了172个胎儿。其中,根据阿斯迪亚或医学图表审查,149人患有肾脏异常,对应于87%的PPV(95%CI:81%-91%)。DNPR的估计完整性为43%(95%CI:38%-49%),Agradia的估计完整性为75%(95%CI:70%-79%)。
    结论:在丹麦,几乎所有的活产婴儿都在妊娠中期接受了扫描。然而,低完整性可能会阻碍DNPR用于产前检测到的严重畸形的研究,并且可以优选地考虑使用Agraya数据库。
    OBJECTIVE: Restricting studies of severe congenital malformations to live-born children may introduce substantial bias. In this study, we estimated the attendance to the second-trimester fetal malformation screening program. We also estimated the positive predictive value (PPV) of prenatally assigned International Classification of Disease-10 diagnoses recorded in the Danish National Patient Registry (DNPR) and the completeness of case registration. We used kidney anomalies as an example.
    METHODS: We identified the proportion of all Danish live-born children from January 1, 2007 to December 31, 2012, who were scanned during the second trimester using the DNPR and the Civil Registration System. Details of all fetuses with specific kidney anomaly diagnoses according to the DNPR were retrieved. The PPV was estimated using the nationwide Astraia database of pregnancy medical charts or traditional medical charts, as gold standard. The completeness was assessed using the total number of cases estimated by the capture-recapture method.
    RESULTS: Of 372,263 live born infants, 97.3% were scanned during the second trimester. We identified 172 fetuses in the DNPR. Of these, 149 had kidney anomalies according to Astraia or medical chart review, corresponding to a PPV of 87% (95% CI: 81%-91%). The estimated completeness was 43% (95% CI: 38%-49%) for the DNPR and 75% (95% CI: 70%-79%) for Astraia.
    CONCLUSIONS: Almost all live-born children were scanned during the second trimester in Denmark. However, low completeness may hamper the use of the DNPR for studies of prenatally detected severe malformations, and use of the Astraia database may preferably be considered.
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