#1
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ÎÀÊ îòêëîíåíèÿ
Äîáðûé äåíü
Ñûíó 3 ãîäà è 7 ìåñÿöåâ, âåñ 16 êã, ðîñò106 ñì, ðîäèëñÿ ñ âåñîì 3460 êã, ïóòåì ÏÊÑ Íà ïðîòÿæåíèè äâóõ ëåò ãåìàòóðèÿ (äî 12 ýðèòðîöèòîâ â ïîëå çðåïèÿ è ïðè ÎÐÂÈ äî 30-40 â ïîëå çðåíèÿ, òî åñòü ïðè òåìïåðàòóðå ãåìàòóðèÿ óñèëèâàåòñÿ). Äåëàëè ñåêâåíèðîâàíèå ýêçîìà äëÿ ïîèñêà ìóòàöèé, ñâÿçàííûõ ñ íàñëåä çàáîëåâàíèÿìè ïî÷åê, èõ íå îáíàðóæèëè Èùåì äàëüøå Ñåé÷àñ ñäàëè ÎÀÊ è áèîõèìèþ êðîâè è ìî÷è  ÎÀÊ óâåëè÷åí ñðåäíèé îáúåì ýðèòðîöèòà. Ýòî ÷òî òî çíà÷èò? ß ïðàâèëüíî ïîíèìàþ, ÷òî íóæíî ïðîâåðèòü óðîâåíü ôîëèåâîé êèñëîòû, âèòàìèíà  è Òòã?  áèîõèìèè óâåëè÷åí èììóíãëîáóëèí Å. Ýòî àëëåðãèÿ? È åùå ïîíèæåí óðîâåíü ìî÷åâîé êèñëîòû â êðîâè è ìî÷åâèíû â ìî÷å.  ìî÷å ó ðåáåíêà ïîñòîÿííî ïîíèæåí êðåàòèíèí ×òî ýòî ìîæåò áûòü? Íóæíû ëè êàêèå òî äîï èññëåäîâàíèÿ? Áóäó áëàãîäàðíà çà Âàøè îòâåòû, óâàæàåìûå äîêòîðà |
#2
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Íè÷åãî íå çíà÷èò ñðåäíèé îáúåì ýðèòðîöèòà ó ðåáåíêà = äà åøå è íîðìû íà áëàíêå ìîãóò áûòü íåâåðíûå äî 90-92 íîðìà; ïëþñ ó÷èòûâàÿ íåêîòîðîå ñíèæåíèå êîíöåíòðàöèè, åòî ïñåâäî-óâåëè÷åíèå ìæåò áûòü èç-çà ðàçäóâàíèÿ åðèòðîöèòîâ â ïðîáèðêå èç-çà ãèïîòîí. ðàñòâîðà, íóæíî ñìîòðåòü âûøåëî÷åííûå ëè åðèòðîöèòû èëè íåò, åñëè ïåðâîå, òî ìîæåò êðîâèòü èç ïî÷åê, åñëè âòîðîå, òî ìî÷åâûâîä. ïóòåé, ñäåëàéòå ðåáåíêó ïðîòðîìáèí - åñëè ñíèæåí, ÌÍÎ ïîâûøåíî, òî ãåìàòóðèÿ ìîæåò áûòü èç-çà äåôèöèòà âèòàìèíà Ê
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#3
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Öèòàòà:
Áëàãîäàðþ çà Âàø îòâåò Äàííûå àíàëèçû ñäàâàëè (âî âëîæåíèè) Ýðèòðîöèòû èçìåíåííûå |
#4
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ôèáðèíîãåí ó ðåáåíêà òîæå â íîðìå; áûòü ìîæåò, âàì ïðèãîäèòñÿ òàêîå:
The prevalence of isolated asymptomatic microscopic hematuria in children is most commonly reported to be between 0.5% and 1% [19, 20]. Of this group, as many as 1 in 4 will have a normalization of urinalysis in 5 years. episodic microscopic hematuria that is accompanied by fever or other infectious symptoms could be indicative of IgA nephropathy or UTI. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#5
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Öèòàòà:
Ðåáåíêà óæå âäîëü è ïîïåðåê èçó÷èëè ñ ýòîé ãåìàòóðèåé, îñòàëàñü òîëüêî áèîïñèÿ... Ïîêà íà íåå íå ðåøàåìñÿ ß çà ýòè 2 ãîäà ñòîëüêî èíôîðìàöèè èçó÷èëà è ñòîëüêî âðà÷åé ïîñåòèëè (è ìîñêîâñêèõ, íàøèõ åêàòåðèíáóðãñêèõ è äàæå îíëàéí êîíñóëüòàöèþ äîêòîðà èç Îðåíáóðãà) ß äóìàþ, ÷òî ýòî ëèáî Ñèíäðîì Àëüïîðòà (ãåíåòè÷åñêèé òåñò âåäü ìîã íå ïîêàçàòü), ëèáî íåôðîïàòèÿ Áåðæå (õîòÿ äîêòîðà ãîâîðÿò, ÷òî äëÿ IgA íåôðîïàòèè âîçðàñòà äåáþòà (1 ãîä è 10 ìåñÿöåâ) íå õàðàêòåðåí) À ìîæåò ýòî ÷òî òî àíàòîìè÷åñêîå, ïî ÓÇÈ âîçìîæíî íå âèçèàëèçèðóåòñÿ, íî òîãäà ïî÷åìó ïðè ïîâûøåíèè òåìïåðàòóðû ãåìàòóðèÿ óñèëèâàåòñÿ |
#6
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åùå òàêîå - ó áîëüøèíñòâà äåòåé ñ ìèêðîãåìàòóðèåé ïðè÷èíó âûÿâèòü íå óäà¸òñÿ; ñàìîå ÷àñòîå - ýòî èçá. âûâåäåíèå ñîëåé êàëüöèÿ áåç êàìíåîáðàçîâàíèÿ, åñëè â ñåìüå åñòü îòÿã. íàñëåäñòâåííîñòü ïî êàìíåîáðàçîâàíèþ, òî íóæíî èñêëþ÷àòü ýòó ïðè÷èíó, çàîäíî - êîãäà áûëà ïîêàçàíà áèîïñèÿ (òîëüêî â 2 ñëó÷àÿõ)
n 274 patients (80%), no cause for the hematuria was uncovered. The most frequent cause detected (16% of patients) was hypercalciuria in the absence of stone disease. Interestingly, 20% of these patients had a family history of stone disease. One patient had hypercalciuria and nephrolithiasis. Post–streptococcal glomerulonephritis (as defined by microscopic hematuria, a positive serum test result for streptococcal antibodies, and a low C3 level, all of which returned to normal within 3 months) occurred in 4 patients. Four patients had structural abnormalities of the urinary tract (2 had duplex collecting systems, 1 had a solitary kidney, and 1 had a unilateral hypoplasia). Two patients underwent kidney biopsy. One had persistent high-grade microscopic hematuria; the biopsy showed IgA nephropathy. The second had microscopic hematuria and a persistently low C3 level; the biopsy showed membranoproliferative glomerulonephritis.//The Clinical Significance of Asymptomatic Gross and Microscopic Hematuria in Children.2005
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#7
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Öèòàòà:
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