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Urinothorax associated with VURD syndrome
Chien-Chang Lee1, Cheng-Chung Fang, Hung-Chieh Chou
1Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Pediatric Nephrology (Berlin, Germany)
|February 16, 2005
Summary
VURD syndrome, a rare congenital condition, can present with urinothorax, a buildup of urine in the chest. Prompt treatment of valve ablation and urinary catheterization led to excellent renal recovery in a unique case.
Area of Science:
- Pediatric Urology
- Congenital Genitourinary Anomalies
- Nephrology
Background:
- VURD syndrome is a congenital genitourinary anomaly characterized by posterior urethral valves, unilateral vesicoureteral reflux, and renal dysplasia.
- Urinothorax, a rare complication of obstructive uropathy, involves urine accumulation in the pleural space.
- The association between VURD syndrome and urinothorax has not been previously reported.
Observation:
- A case of VURD syndrome presented with acute renal failure and respiratory distress syndrome.
- The patient developed urinothorax, a previously unlinked complication of VURD syndrome.
- Diagnosis of urinothorax was confirmed by a pleural fluid to serum creatinine ratio > 1.
Findings:
- Urinothorax resolved rapidly with urinary catheterization, without the need for tube thoracotomy.
- Primary valve ablation led to excellent renal recovery.
- The study suggests urinothorax and urinoma may be part of the VURD syndrome spectrum.
Implications:
- This case highlights the importance of considering urinothorax in VURD syndrome patients with respiratory distress.
- The findings suggest a potential protective role of urinoma, urinothorax, and unilateral reflux in preserving renal function.
- Management involving prompt urinary catheterization and valve ablation can lead to favorable renal outcomes in VURD syndrome with complications.