Urolithiasis in Tunisian children: a study of 120 cases based on stone composition |
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Authors: | Ayoub Kamoun Michel Daudon Jaouida Abdelmoula Mourad Hamzaoui Béji Chaouachi Tawfik Houissa Amel Zghal Slim Ben Ammar Chelbi Belkahia Rachid Lakhoua |
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Institution: | Service de Pédiatrie, H?pital Charles Nicolle, Tunis, Tunisia, Laboratoire CRISTAL, Service de Biochimie A, H?pital Necker, AP-HP, Paris, France, FR Laboratoire de Biochimie, H?pital Charles Nicolle, Tunis, Tunisia, Service de Chirurgie Pédiatrique, H?pital d’Enfants, Tunis, Tunisia,
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Abstract: | The composition of urinary stones in children depends on socioeconomic conditions and hygiene, geographical area, and dietary
habits. We analyzed urinary stones from 120 consecutive Tunisian children (81 males, 39 females) aged 5 months to 15 years.
The stone was located in the upper urinary tract in 91 cases (76%). Stone analysis included both a morphological examination
and an infrared analysis of the nucleus and the inner and peripheral layers. The main components of bladder calculi were whewellite
(69%) and struvite (22%), whereas the main component of upper urinary tract calculi was whewellite (67%). The nucleus of bladder
stones was composed of ammonium urate (45%), struvite (28%), cystine (10%), and carbapatite (7%). The nucleus of kidney and
ureteral calculi was mainly composed of ammonium urate (38%), whewellite (24%), carbapatite (13%), or struvite (11%). Based
on stone composition, urinary tract infection was involved in the nucleation or growth of a third of calculi. Endemic urolithiasis
involving simultaneous nutritional, metabolic, and infectious factors, and defined by its nucleus composed of ammonium urate
without struvite, represented 40% of cases. Exclusive metabolic factors – including genetic diseases such as primary hyperoxaluria,
cystinuria, and hypercalciuria – were responsible for less than 25% of cases.
Received: 6 March 1998 / Revised: 22 March 1999 / Accepted: 22 March 1999 |
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Keywords: | Urinary calculi Stone morphology Infrared analysis Tunisia Etiology Ammonium urate |
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