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Pediatric urolithiasis: metabolic risk factors and follow-up results in a Turkish region with endemic stone disease.
[cystinuria]
The
goal
of
this
study
was
to
investigate
the
metabolic
etiology
,
clinical
findings
and
medical
treatment
of
children
with
urolithiasis
in
an
endemic
region
of
Turkey
.
We
retrospectively
analyzed
the
medical
records
of
742
(
437
males
,
305
females
)
children
with
urolithiasis
.
Physical
examination
results
,
serum
biochemistry
and
urine
metabolic
evaluation
,
including
urinary
citrate
,
oxalate
,
calcium
,
uric
acid
,
cystine
and
magnesium
levels
were
recorded
.
We
obtained
follow-up
records
in
316
patients
to
evaluate
the
association
between
stone
recurrence
and
metabolic
risk
factors
.
The
mean
age
at
diagnosis
was
2
.
6
±
3
.
4
(
0
.
1
-
17
.
0
)
years
.
Male
-
to
-
female
ratio
was
1
.
4
:
1
.
A
family
history
of
stone
disease
was
found
in
76
.
5
%
of
patients
and
41
%
of
parents
had
consanguineous
marriage
.
The
most
common
presenting
symptoms
were
urinary
tract
infection
(
UTI
,
23
.
9
%
)
and
hematuria
(
23
.
6
%
)
.
Metabolic
abnormalities
were
found
in
588
(
79
.
2
%
)
patients
,
including
hypercalciuria
in
31
.
5
%
,
hypocitraturia
in
24
.
2
%
,
hyperoxaluria
in
11
.
4
%
,
hyperuricosuria
in
9
.
1
%
,
hypomagnesuria
in
3
.
9
%
,
and
cystinuria
in
3
.
1
%
of
patients
.
The
frequency
of
hyperoxaluria
and
hypocitraturia
were
significantly
higher
in
patients
with
new
stone
formation
.
Follow-up
records
of
316
(
42
.
6
%
)
patients
(
192
males
,
124
females
)
were
available
.
Urolithiasis
was
shown
in
135
(
42
.
7
%
)
of
the
patients
on
control
ultrasonography
,
and
61
.
5
%
of
these
patients
had
a
stone
size
≤
3
mm
.
Hyperoxaluria
and
cystinuria
were
significantly
higher
in
patients
with
stone
persistence
.
The
main
goal
of
management
for
children
with
urolithiasis
should
be
identification
of
risk
factors
.
Diseases
Validation
Diseases presenting
"female ratio"
symptom
carcinoma of the gallbladder
cystinuria
dracunculiasis
hirschsprung disease
hodgkin lymphoma, classical
hydrocephalus with stenosis of the aqueduct of sylvius
legionellosis
liposarcoma
malignant atrophic papulosis
primary hyperoxaluria type 1
pyomyositis
typhoid
waldenström macroglobulinemia
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