CLINICAL-LABORATORY MARKERS OF FIBRILOGENESIS DISORDERS IN THE SEVERITY OF PYELONEPHRITIS IN CHILDREN

Natalia Lukyanenko, Mariana Iskiv

Abstract


Aim of the research: to establish the role of undifferentiated connective tissue dysplasia, as a manifestation of violation of fibrillogenesis, in the severity of the course of pyelonephritis in children.

154 children with pyelonephritis from 3 to 18 years were examined. As a result of catamnestic surveillance, they were divided into 2 groups: I – 92 persons, children with chronic pyelonephritis in which were diagnosed 3 or more episodes of relapse of pyelonephritis during the year, and II – 56 children with acute pyelonephritis, in which during the year no relapses were noted. The control group were 65 somatically healthy children of the same age (III - health-control). All children had a routine comprehensive clinical and laboratory examination and clinical and laboratory markers of a fibrillogenic disorder were established.

In children with chronic pyelonephritis, the frequency of all analyzed complaints was significantly higher than in children with acute pyelonephritis without relapses: frequent headaches – 56.52 % versus 25.0 %, appetite loss – 28.26 % vs. 19.64 %, frequent abdominal pain – 52.17 % vr. 32.14 %, increased fatigue – 41.30 % vr. 28.57 %.

In children with chronic pyelonephritis, phenotypic signs of undifferentiated connective tissue dysplasia (UCTD) were significantly more marked, such as joint hypermobility (in 52.0 % of children versus 5.4 %), asthenic body structure (59.0 % vs. 26.78 %), visual disturbance (84.8 % vs. 32.14 %), chest deformity (42.4 % vs. 8.9 %), scoliosis (52.17 % vs 10.7 %), arachnodactyly and predisposition to bleeding were observed only in children of the 1st group (22.5 % and 4.34 % respectively).

In practically all children with chronic pyelonephritis, the values of free and bound oxyproline fractions in blood plasma were significantly increased (47.14±0.03 μmol/l and 40.08±0.03 μmol/l, respectively), according to arithmetic meanings, reliably differing from the data of children with acute pyelonephritis (17.65±0.01 μmol/l and 17.22±0.02 μmol/l), in which these oxyproline fractions were elevated only in 12.0 % and 16.0 % of the subjects.

In 97.0 % of children with chronic pyelonephritis, the level of oxyproline in urine was elevated and significantly exceeded the level of excretion of oxyproline in urine in children with acute pyelonephritis.

The presence of UCTD in a child plays an important role in the process of chronic pyelonephritis, and children with its manifestations have a heavier course of disease with frequent relapses, therefore, the presence of signs UCTD is prognostically unsuccessful, which dictates the need for the appointment of metabolic therapy in the first episodes of the disease in children, if they have clinical and laboratory manifestations of UCTD.


Keywords


children; dysplasia of connective tissue; violations of fibrillogenesis; clinical and laboratory markers; oxyproline ; pyelonephritis; kidneys

Full Text:

PDF

References


Nyan'kovs'kiy, S. L., Dobrik, O. O., Іs'kіv, M. Yu. (2016). Metabolіchna terapіya tarol' u kompleksnomu lіkuvannі displazіy spoluchnoi tkanini u dityachіynefrologіyi. Sovremennay apediatriya, 1 (73), 131–136. doi: 10.15574/sp.2016.73.131

Ivanov, D. D., Korzh, O. M. (2014). Nefrologіya v praktyci sіmeynogo lіkarya. Donetsk: Publissher Zaslavsky A. Yu., 464.

Sinitskaya, V. O.,Pavlyshyn, G. A., Chubata, O. B. (2008). Metabolіchna terapіya v kompleksnomu lіkuvannі sindromu displazіyi spoluchnoy tkanini u dіtey. ML, 8 (54), 89–90.

Yevtushenko, S. K. (Ed.) (2009). Connective Tissue Dysplasiain Neurologyand Pediatrics (Clinical Picture, Diagnostics, Treatment) Guidelines for physicians. Donetsk: Publisher Zaslavsky A. Yu., 372.

Kadurina, T. I., Gorbunova, V. I. (2009). Displaziya soedinitel'noy tkani. Rukovodstvo dlya vrachey. Sankt-Peterburg: Elbi-SPb, 704.

Solyenko, O. V., Rykalo, N. A., Osypenko, I. P., Soleyko, L. P. (2014). Syndrom nedyferentsiyovanoyi dysplaziyi s poluchnoyi tkanyny: vid kontseptsiyi patohenezu do stratehiyi likuvannya. Vinnytsya: Nova Knyha, 166.

Volovar, O. S. (2013). Fenotypovioznakydysplaziyispoluchnoyitkanyny u patsiyentivizzakhvoryuvannyamy skronevo-nyzhnʹoshchelepnoho suhloba. Ukrayins’kyy medychnyy chasopys, 2 (94), 188–192.

Zaremba, E. Kh., Rak, N. O. (2015). Proyavi nediferentsіyovanoi displazіyi spoluchnoi tkanini z boku sertsevo-sudinnoi sistemi u khvorikh na arterіal'nugіpertenzіyu. AML XXI, 2, 14–18.

Kazimirko V. K., Ivanitskaya, L. M., Dubkova A. H., Silant’yeva, T. S. Yvanova, H. P., Poludnenko, M. F. et. al. (2013). Trudnoshchi diahnostyky nedyferentsiyovanoyi dysplaziyi spoluchnoyi tkanyny u praktytsi likarya-revmatoloha. Ukrayins’kiy revmatolohichniy zhurnal, 3 (53), 96–100.

Timochko-Voloshin, R., Mukhіn, V. (2014). On the problem of connective tissue dysplasia in children: means of physical rehabilitation. Physical activity health and sport, 1 (15), 46–53.

Nazarenko, L. G. (2010). Dysplasia of connecting work: the role of elimination and gestational problems. Women's Doctor, 1, 42–48.

Kuprienko, N. B., Svetlova, Z. V., Smirnova, N. N. (2017). Metabolic basis of urinary tract infection prophylaxis in children. The Scientific Notes of the I. P. Pavlov St. Petersburg State Medical University, 24 (1), 22–27. doi: 10.24884/1607-4181-2017-24-1-22-27

Nestorenko, Z. V. (2012). Displaziya soedinitel'noy tkani – mediko-sotsial'niy fenomen XXI veka. Bol'. Sustavy. Pozvonochnik, 1 (5), 17–23.

Povshedna, T. Yu., Shevchuk, D. V., Kornіychuk, N. M. (2015). Rol' svoechasnogo lіkuvannya vrodzhenikh vad rozvitku sechovidіl'noy sistemi v poperedzhennі khronіchnoy nirkovoy nedostatnostі u dіtey. Bіologіchnі doslіdzhennya, 423–429.

Lukyanenko, N. S., Kens, K. A., & Petritsa, N. A. (2016). Evaluating the Diagnostic Value of the Tissue Hypoxia, Membrane Destruction and Undifferentiated Connective Tissue Dysplasia Markers in Young Children with Vesicouretheral Reflux. Child`s health, 6 (74), 86–92. doi: 10.22141/2224-0551.6.74.2016.82138

Nakaz MOZ Ukraini No. 627 vіd 03.11.2008 «Pro zatverdzhennya protokolu lіkuvannya dіtey z іnfektsіyami sechovoi sistemi і tubuloіnterstitsіal'nim nefritom».

Beighton, P., de Paepe, A., Danks, D., Finidori, G., Gedde-Dahl, T., Goodman, R. et. al. (1988). International nosology of heritable disorders of connective tissue, Berlin, 1986. American Journal of Medical Genetics, 29 (3), 581–594. doi:10.1002/ajmg.1320290316

Yur'yeva, E. A., Dlin, V. V. (2002). Diagnosticheskiy spravochnik nefrologa. Moscow. Overley, 12–13.

Sharaev, P. N. (1981). Metod opredeleniya svobodnogo i svyazannogo oksiprolina v syvorotkekrovi. Laboratornoe delo, 283–285.

Borovikov, V. (2001). Statistica: iskusstvo analiza dannykh na komp'yutere. Dlya professionalov. Sankt-Peterburg: Piter, 656.




DOI: http://dx.doi.org/10.21303/2504-5679.2018.00581

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 Natalia Lukyanenko, Mariana Iskiv

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2504-5679 (Online), ISSN 2504-5660 (Print)