Introduction:The purpose of this study was to evaluate the characteristics of patients with nocturnal enuresis (NE).Methods:We enrolled 403 children with NE referred to the Services of Pediatrics, Campus Bio-Medico University Hospital of Rome between June 2013 and July 2018. We excluded 2 children, respectively, with renal agenesis and chromosomopathy.Results:Of the 401 patients, 101 girls (25.2%) and 300 boys (74.8%), aged 5–16 years; mean age at first visit 8.8 ± 2.44 years. During the physical examination, we asked the patients and their parents specific questions to identify signs and symptoms of voiding disorders and comorbid conditions. In addition, we evaluated family history and behavioral characteristics of patients. In this study, NE was heredity in the 31.2% of cases. We found urogenital abnormalities in 15.7% of cases, constipation in 14.5% of cases, innocence heart murmur in 21.4% of cases and parasomnias in a good percentage of cases, especially snoring (13.7%), restless sleep (5.7%), somniloquy (23.7%) and bruxism (14.7%).Conclusions:Our experience demonstrates that there are a lot of comorbidities that are associated with NE and can influence the prognosis and the response to the therapy in these children.
renal involvement being the principal cause. It requires close monitoring and treatment. Renal biopsies can be important prognostic markers and guide best management.(2) Currently, there have been no significant randomised controlled trials detailing best management and hence treatment varies significantly. This study reviews practice in a national tertiary renal unit in Ireland over a fifteen-year period. Aims 1. Identify children who had a renal biopsy.2. Review Medical management, duration of therapy and follow up. Methods This was a retrospective review between September 2001 to April 2017. Data was collated by computer and paper records, online haematological and radiological resources. This review excludes children managed in another tertiary centre in Ireland. ResultsThe main outcomes were patient demographics, (i) Biopsy findings: Acute vs Chronic and staging classification, (ii) Drug Treatment and Duration (iii) Follow up: urinanalysis at interval time points, renal ultrasonography and renal function. Thirty children had a renal biopsy. 10 For persistent proteinuria, 2 for recurrent episodes, deranged renal function, mixed nephritic/nephrotic, IgA vs HSP respectively and 12 not classified.73% required medical treatment, the majority polypharmacy. When immunosuppressants were needed a combination of steroids and Mycophenolate Acid were most commonly used. 73% required medical treatment for over eighteen months with evidence of proteinuria often guiding duration.Regular follow up included urinanalyis, renal bloods, ultrasonography and blood pressure measurement.To standarise care nationally, a basic guideline was created to aid appropriate referral to our tertiary centre. Conclusion HSP is rare but can cause significant morbidity. RCTs are required to determine best management and to standardize care nationally and internationally P559
investigations. Of the 7 diagnosed: 3 had mutations in Connexin 26 gene (CNX), 2 had congenital cytomegalovirus (CMV) infections, and 2 had structural abnormalities of the innerear. Conclusion In our small cohort, aetiological assessment was successful in establishing a diagnosis in 78% of cases of PCHI identified by the UNHS. The top 3 investigations to aid diagnosis include MRI Brain & Internal Auditory Meati, Urinary CMV, andCNX 26 genetics.
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