ID | 59903 |
FullText URL | |
Author |
Hasegawa, Kosei
Department of Pediatrics, Okayama University Hospital
ORCID
Kaken ID
publons
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
Kaken ID
publons
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
|
Abstract | 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.
|
Keywords | adrenocorticotropic hormone therapy
calcium
crystal
renal tubular epithelial cell
urinary sediment
|
Note | 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.
|
Published Date | 2020-01-19
|
Publication Title |
Pediatrics International
|
Volume | volume62
|
Issue | issue5
|
Publisher | Wiley
|
Start Page | 587
|
End Page | 592
|
ISSN | 1328-8067
|
NCID | AA11320483
|
Content Type |
Journal Article
|
language |
English
|
OAI-PMH Set |
岡山大学
|
Copyright Holders | © 2020 Japan Pediatric Society
|
File Version | author
|
PubMed ID | |
DOI | |
Web of Science KeyUT | |
Related Url | isVersionOf https://doi.org/10.1111/ped.14158
|