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KMID : 0367419620030010058
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Journal of Korean Pediatric Society
1962 Volume.3 No. 1 p.58 ~ p.62
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A CASE OF RENAL RICKETS
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張在暹/Chgng, Chai Sum
鄭忠基/Chung, Choong Ki
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Abstract
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A case of hyperphosphatemic renal reckets occuring in 2 % years old boy is presented. His-mother noticed slowly developing thirst and polyuria since one year of age. Evidence from clinical and Iaboratory data are presented to show that glomerular insufficiency due to hydrone plirosis and hydroureter possibly following bladder neck contracture was the cause of the rickets. Clinical and Iabnratory data revealed ployuria with constant low specific gravity and high phosphorus marked proteinuria without glucosuria and diminished urinary excretion of chloride and phosphorus. Chemical study of blood serum revealed highly elevated phosphorus and NPN with -slightly lowered Ca and normal alkaline phosphatase.
Radiologic finding of the chest revealed marked swelling at the chostochondral junctions and that of wrist revealed broadning, cupping and fraying of the distal ends of the radius and ulna. Dehydration and ployuria were not corrected by adrerocorticaI steroid and pitressin. The rackitic finding of the bones did not improved with vitamin D. I. V. P and cystognaphy revealed marked dilatation of the ureter, renal pelvis and renal calices and fibrous contrecture of the bladder neck.
His condition did not improve with treatment. He died with pulmonary edema two months after admission. Early detection_ with early application of cystography in children with any evidence of renal insufficiency is emphasized in order to exert pertinent treatment.
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