Risk Factors for Urolithiasis in Gastrostomy Tube Fed Children: A Case-Control Study

Johnson, Emilie K.; Lightdale, Jenifer R.; Nelson, Caleb P.

doi:10.1542/peds.2012-2836

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Table 1 summarizes the particularly significant adverse effects of AEDs in patients with SMID. Among others, urolithiasis is a well known complication due to TPM, ZNS, PHT and AZA [17][18][19][20]. In this study, CT im- PHT or AZA, and in 10 of 50 patients not taking the above AEDs.…”

Section: Discussionmentioning

confidence: 72%

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Saito¹,

Hirabayashi²,

Kita³

et al. 2020

E&S

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To descr ibe the potentially ser ious adver se effects of antiepileptic dr ugs (AEDs) in individuals with severe motor and intellectual disabilities (SMID) and to improve the quality of drug treatment for these patients. Methods: The data of 99 SMID patients with epilepsy staying at an institute for mor e than 1 year were retrospectively reviewed. Each patient was taking 3.4 ± 1.6 (range, 1-8) kinds of AEDs, and clinical seizures were still prevalent in 68 patients. Results: Discontinuation or dose r eduction of AEDs amelior ated agitation and/or sleep disturbance, somnolence, vomiting, appetite loss, and stridor in the corresponding patients, and additionally resolved serious gastrointestinal or cardiorespiratory problems in three patients whose clinical courses were detailed. Patient 1 manifested aerophagia-related chronic distension of the abdomen causing mechanical ileus, requiring repeated intestinal resection. The abdominal distension improved significantly after discontinuation of acetazolamide. Patient 2 experienced progressive motor deterioration during young adulthood, with simultaneous sudden elevation in blood phenytoin level. Although motor disability persisted, resolution of hypoventilation was noted after cessation of phenytoin. Patients 3 had long-term use of carbamazepine and exhibited episodic bradycardia (heart rate as low as 25 bpm) that resolved after drug discontinuation. Conclusions: Patients with SMID sometimes fail to effectively ver balize subjective adver se effects of medications to healthcare providers. The chronic adverse effects of AEDs, including those described in this study, should be broadly evaluated for better patient management.

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Section: Discussionmentioning

confidence: 72%

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Saito¹,

Hirabayashi²,

Kita³

et al. 2020

E&S

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show abstract

“…Pain assessment in children with cognitive impairment andchronicillness such as cerebral palsy or syndromic diseases ischallenging,and a clinical diagnosis of urinary tract infection orlithiasis canbe di cult. Remarkably, these patients are prone tobe affected byurinary stones, due to several predisposing factorssuch ashypercalciuria, bone demineralization,dehydration 5 andtopiramate treatment forconcomitant epilepsy 6 .Struvite stones are a subset ofkidney stones, composed of magnesiumammonium phosphate (struvite)and calcium carbonate-apatite, whichform as a result of urinarytract infections with urease-producingpathogens. It is known thatthis type of stone is formed quickly,within a few weeks, in thepresence of urease producingbacteria 7 , from generasuch as Proteus,Providencia, Klebsiella, Staphylococcus.…”

Section: Discussionmentioning

confidence: 99%

Struvite stones causing recurrent pain in a child with cerebral palsy: a lesson for a pragmatic approach to pain in children with cerebral palsy and cognitive impairment.

Trombetta¹,

Benvenuto²,

Peri³

et al. 2020

Preprint

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Background Children with severe cognitive impairments (CI) from any cause, such as cerebral palsy (CP), dysmorphic or chromosomal syndromes, traumatic brain injury, neurodegenerative disorders, and epileptic syndromes, experience pain more frequently than healthy peers. Although it is a common problem, pain is many times unrecognized because these patients are often unable to self- verbalize it or exhibit uncommon behaviors when they experience it, leading to a delay in the recognition and management of pain by the physicians. Untreated chronic or recurrent pain profoundly affects the quality of life of these children and interferes with their performance and adaptive function. Recognition, measurement, and treatment of pain in this population is challenging, and a clinical diagnosis of urinary tract infection or lithiasis may not be immediate. Case presentation: We report the case of an eight-year-old child with cerebral palsy who was admitted for recurrent abdominal pain lasting for one month. While blood laboratory tests were all in the normal range, the diaper examination revealed multiple stones. Urine culture tested positive for Providencia stuartii, a Gram-negative bacteria, and an antibiotic treatment with ceftibuten was started for two weeks. The patient fully recovered in three days without any recurrence. Conclusions urine analysis, to detect an infection, and renal and bladder US, to rule out stones, should be systematically considered in patients with cognitive impairment with unexplained pain. In a pragmatic, concise approach, the basic principles of diagnosis and treatment of pain in children with cognitive impairment are reviewed.

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“…The patient’s history, laboratory tests, and dental and orthopedic evaluations had already ruled out frequent sources of pain for children with cerebral palsy, such as common infections, constipation, abdominal emergencies, caries, bone fractures, and hip dislocation. Children with cerebral palsy are, in general, more prone to be affected by urinary stones, due to several predisposing factors such as hypercalciuria, bone demineralization, dehydration [ 1 ], and topiramate treatment for concomitant epilepsy [ 2 ]. Struvite stones, in particular, are a subset of kidney stones, composed of magnesium ammonium phosphate (struvite) and calcium carbonate-apatite, which form as a result of urinary tract infections (UTIs) with urease-producing pathogens.…”

Section: Answersmentioning

confidence: 99%

Recurrent pain in a child with cerebral palsy: Answers

2021

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Risk Factors for Urolithiasis in Gastrostomy Tube Fed Children: A Case-Control Study

Cited by 13 publications

References 24 publications

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Struvite stones causing recurrent pain in a child with cerebral palsy: a lesson for a pragmatic approach to pain in children with cerebral palsy and cognitive impairment.

Recurrent pain in a child with cerebral palsy: Answers

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