临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (9): 680-.doi: 10.3969/j.issn.1000-3606.2016.09.011

• 综合报道 • 上一篇    下一篇

儿童 IgA 肾病合并膀胱血管瘤 1 例报告并文献复习

张宏文 1 ,张保 2 ,姚勇 1 ,肖慧捷 1   

  1. 1.北京大学第一医院儿科(北京 100034);2.北京航天中心医院泌尿外科(北京 100049)
  • 收稿日期:2016-09-15 出版日期:2016-09-15 发布日期:2016-09-15
  • 通讯作者: 肖慧捷 E-mail:huijiexiao2@hotmail.com

IgA nephropathy combined with hemangioma of bladder in children: a case report

ZHANG Hongwen1, ZHANG Bao2, YAO Yong1, XIAO Huijie1   

  1. 1. Department of Pediatric, Peking University, First Hospital, Beijing 100034, China; 2. Department of Urinary Surgery, Space Center Hospital, Beijing 100049, China
  • Received:2016-09-15 Online:2016-09-15 Published:2016-09-15

摘要: 目的 探讨儿科临床血尿性疾病的诊断思路。方法 总结分析1例IgA肾病合并多发性膀胱血管瘤患儿的临 床资料。结果 女性患儿, 9岁,临床表现为多次呼吸道感染后诱发间断肉眼血尿、持续性镜下血尿,伴尿中血凝块6年余, 尿常规蛋白+++,RBC满视野/HP;24 h尿蛋白定量0.54~1.02 g,肾早期损伤指标以微量白蛋白为主;腹部、泌尿系超声 未见异常;泌尿系增强CT扫描未见异常;肾动脉造影未见动静脉畸形或瘘;肾活检病理诊断为局灶增生性IgA肾病;膀 胱镜检查提示多发性血管瘤。结论 儿童膀胱血管瘤临床较为罕见,对于表现为肉眼血尿伴血凝块,影像学检查无明确异 常或其他疾病者,如IgA肾病诊断后治疗不满意,应行膀胱镜检查,以除外膀胱血管瘤的可能。

Abstract:  Objective To explore the diagnosis of pediatric clinical hematuria disease. Methods The clinical data of one pediatric patient with IgA nephropathy combined with multiple bladder hemangioma were summarized and analyzed. Results For more than 6 years, 9-year-old female presented with repeated intermittent gross hematuria and persistent microscopic hematuria with the blood clot in urine after several respiratory tract infections. Routine urine test showed protein +++, RBC in full field of vision/HP, and 0.54-1.02 g of 24 h urine protein quantitation. Early damage index of kidney is mainly based on microalbumin. The ultrasound showed no abnormal abdomen and urinary tract. Also there was no abnormality in enhanced urinary tract CT scan. Renal arteriography showed no fistula or arteriovenous malformation. Pathological diagnosis of renal biopsy was focal proliferative IgA nephropathy. Cystoscopy examination suggested multiple hemangioma of bladder. Conclusion Bladder hemangioma is a rare condition in childhood. For children presented gross hematuria with blood clots, when the imaging finds no abnormalities or other diseases and the treatment of IgA nephropathy is unsatisfatry after diagnosis, the cystoscopy should be performed to exclude the possibility of bladder hemangioma.