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Vesicoureteric reflux deterioration in monozygotic twins
Spyridon Tsiouris1, Chrissa Sioka, Anna Marinarou
1Nuclear Medicine Department, Pediatric Nephrology Clinic, University General Hospital of Ioannina, Ioannina, Greece. spytsi@gmail.com
Indian Journal of Pediatrics
|April 1, 2008
Summary
Identical twins with primary vesicoureteric reflux (VUR) showed similar clinical progression. Early diagnosis and management of VUR in infants and siblings are crucial for better outcomes.
Area of Science:
- Pediatric Nephrology
- Urology
- Medical Genetics
Background:
- Primary vesicoureteric reflux (VUR) is a common inherited urinary tract disorder.
- Autosomal dominant inheritance patterns are frequently observed in VUR cases.
- VUR can lead to renal damage and recurrent urinary tract infections.
Purpose of the Study:
- To describe the parallel clinical course of VUR in monozygotic twins.
- To highlight the importance of early diagnosis and management in infants with urinary infections.
- To discuss the role of heredity, age, and voiding dysfunction in VUR progression.
Main Methods:
- Case study of monozygotic twins diagnosed with VUR.
- Clinical evaluation including urinary tract infection history and physical examination.
- Diagnostic tools: Renal cortical scintigraphy and urodynamics study.
- Treatment monitoring: Antibiotic prophylaxis and antispasmodic medication.
Main Results:
- Both twins presented with VUR grade II and unilateral renal hypo-dysplasia.
- Recurrent infections occurred despite antibiotic prophylaxis, necessitating treatment changes.
- Urodynamics revealed functional bladder instability in both girls.
- Treatment with oxybutynin showed positive results for bladder instability.
Conclusions:
- Prompt evaluation for VUR is essential in infants with urinary infections.
- Siblings, especially identical twins, have a significantly higher risk of VUR.
- Age, dysfunctional voiding, and genetic factors influence VUR's clinical course.
- Nuclear medicine plays a vital role in VUR diagnosis and management.
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