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多囊肾是一种具有家族性倾向的少见疾病,临床上多见误诊,现就我院收治1例,报告如下。病历摘要患儿男,4岁半。于出生后半年常发热伴眼睑及下肚浮肿。1岁后出现尿频、尿急。多次在当地医院诊为泌尿系感染。2岁半时出现血尿,曾被诊为慢性肾炎急性发作,肾结核等病。此次因发热、咳嗽、眼睑及下肢浮来我院就诊。门诊查尿常规蛋白(++++),白细胞(++++),上皮细胞(++),以泌尿系感染收入院。查体:体温40～42℃,急性病容,极度衰弱。全身淋巴结无肿大。心、肺、肝、脾正常。左下腹略隆起,肾区叩痛阳性。腹部平片示左肾盂扩张,静脉肾盂造影左侧肾盂积水。肾B型超声检查:双侧肾积水,右肾体积增大,左侧多囊肾,左输尿管上段梗阻,左肾脓肿。实验室检查:尿三杯试验均为
Polycystic kidney disease is a rare familial tendency of the disease, more common clinical misdiagnosis, now admitted to our hospital in 1 case, the report is as follows. Summary of medical records Children, 4 years and a half. Six months after birth, fever and eyelid edema. 1 year old urinary frequency, urgency. Many times in the local hospital diagnosed as urinary tract infection. Hematuria occurs at 2 and a half years old and has been diagnosed as acute episode of chronic nephritis and kidney tuberculosis. The fever, cough, eyelids and lower limbs float to our hospital. Outpatient urine routine protein (++++), white blood cells (++++), epithelial cells (++), urinary tract infection hospital. Physical examination: body temperature 40 ~ 42 ℃, acute disease, extremely weak. No swelling of the whole body lymph nodes. Heart, lung, liver, spleen normal. Left lower abdomen slightly elevated, kidney area knocking positive. Abdominal plain film showed left renal pelvis expansion, intravenous pyelography left hydronephrosis. Kidney B-mode ultrasound: bilateral hydronephrosis, right renal enlargement, left polycystic kidney, left upper ureteral obstruction, left renal abscess. Laboratory tests: three cups of urine are