Related Experiment Videos
Calyceal microlithiasis in children: report on 196 cases
A La Manna1, C Polito, F Cioce
13rd Pediatric Clinic, Department of Pediatrics, Second University of Naples, Italy.
Insights
Calyceal microlithiasis (CM) in children, identified by small hyperechogenic spots on renal ultrasound, may indicate early urolithiasis risk. This finding can help explain symptoms and guide early detection of kidney stones.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Urology
Background:
- Urolithiasis in children poses diagnostic challenges.
- Early identification of at-risk children is crucial for prevention.
- Non-specific symptoms can delay diagnosis.
Purpose of the Study:
- To define and characterize calyceal microlithiasis (CM) in children.
- To investigate the association between CM and urolithiasis risk factors.
- To explore the clinical significance of CM in pediatric patients.
Main Methods:
- Retrospective analysis of clinical data from 196 children (aged 0.9-15.9 years).
- Renal ultrasound to identify hyperechogenic spots < 3 mm in renal calyces (CM).
- Review of family history, presenting symptoms, and metabolic evaluations (hypercalciuria, hyperuricuria).
Main Results:
- CM was identified in 196 children.
- A significant family history of urolithiasis was noted in 70.4%.
- Common presenting symptoms included abdominal pain, dysuria, and hematuria.
- Hypercalciuria and hyperuricuria were present in approximately one-third and one-fifth of patients, respectively.
- Of 29 followed patients, 9 developed calculi (4-7 mm) within 2 years.
Conclusions:
- CM may represent an early stage of kidney stone formation in children.
- Identifying CM can aid in explaining non-specific symptoms and potentially reduce invasive diagnostics.
- CM is associated with a family history of urolithiasis and metabolic abnormalities, suggesting a predisposition to stone disease.
Abstract:
Recognition of children at greatest risk for urolithiasis may allow early detection or prevention of stone formation. We report clinical data from 196 children aged 0.9-15.9 years in whom renal ultrasound examination revealed hyperechogenic spots in renal calyces less than 3 mm in diameter. We called this finding "calyceal microlithiasis" (CM). There was a history of urolithiasis in 70.4% of patients in at least one first- or second-degree relative. Presenting symptoms were recurrent abdominal pain, dysuria, and hematuria, occurring alone or in combination. Hematuria was the presenting symptom in 41% of patients and was the only urinary finding in more than one-third. Hypercalciuria was present in about one-third and hyperuricuria in one-fifth of the patients. Of 29 patients who were followed for at least 2 years, 9 developed calculi 4-7 mm in diameter. CM possibly represents the first step in calculus formation. The finding of CM might explain a number of symptoms and signs that are often mild and non-specific, thus reducing invasive diagnostic procedures.