Abstract：Objective: To investigate the treatment of ceftriaxone-induced urolithiasis in infants and children. Methods: A retrospective analysis was performed on 5 children diagnosed with ceftriaxone-induced urolithiasis from August 2015 to April 2016 in our hospital. The clinical features, imaging characteristics and surgical treatments of ceftriaxone-induced urolithiasis were discussed. Results: There were 4 cases or renal colic or bellyache, 4 case of anuria and 1 case of acute renal failure. All cases were diagnosed as having urolithiaiss and/or hydronephhrosis by ultrasonography, and CT. All cases were cured by operation or conservative treatment. Urinary calculi composition was analyzed by Fourier transform infrared spectroscopy (FTIR; LIIR type, Lambda, China). The renal function in all cases was normal and there were no recurrent calculi after short-term follow-up. Conclusions: Ceftriaxone is wided used in infants and children. However, ceftriaxone-induced crystals are composed of calcium and ceftriaxone. Therefore, in children given ceftriaxone, it is necessary to increase fluid intake, and carry out ultrasonography monitoring. Once acute obstruction occurs due to ceftriaxone-induced calculis, indwelling ureteral stent is placed quickly to relieve the obstruction and promote the removal of the calculi.
杜源, 李钧, 肖荆, 王文营, 田野. 婴幼儿及儿童头孢曲松结石的外科治疗[J]. 微创泌尿外科杂志, 2017, 6(6): 352-355.
Du Yuan, Li Jun, Xiao Jing, Wang Wenying, Tian Ye. Surgical treatment of infants and children with ceftriaxone-induced urolithiasis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(6): 352-355.
[1] Katzung BG, Masters SB, Trevor AJ. Basic & clinical pharmacology. New York: McGraw-Hill Medical, 2011:781-784. [2] Brogden RN, Heel RC, Speight TM, et al. Cefuroxime: a review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs, 1979,17(4):233-266. [3] Park HZ, Lee SP, Schy AL. Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate. Gastroenterology, 1991,100(6):1665-1670. [4] Portale AA, Perwad F. "Calcium And Phosphorus," Avner ED, Pediatric Nephrology (2004) 5th edition. Lippincott Williams & Wilkins: Philadelphia, PA. 2004:209. [5] Chutipongtanate S, Thongboonkerd V. Ceftriaxone crystallization and its potential role in kidney stone formation. Biochem Biophys Res Commun, 2011,406(3): 396-402. [6] Biner B, Öner N, Çeltik C, et al. Ceftriaxone-associated biliary pseudolithiasis in children. J Clin Ultrasound, 2006,34(5):217-222. [7] Prince JS, Senac MO. Ceftriaxone-associated nephrolithiasis and biliary pseudolithiasis in a child. Pediatr Radiol, 2003,33(9):648-651. [8] De Moor RA, Egberts ACG, Schröder CH. Ceftriaxone-associated nephrolithiasis and biliary pseudolithiasis. Eur J Pediatr, 1999,158(12):975-977. [9] Acun C, Erdem LO, Sö üt A, et al. Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study. Ann Trop Paediatr, 2004,24(1):25-31. [10] Avci Z, Koktener A, Uras N, et al. Nephrolithiasis associated with ceftriaxone therapy: a prospective study in 51 children. Arch Dis Child, 2004,89(11):1069-1072. [11] Cochat P, Cochat N, Jouvenet M, et al. Ceftriaxone-associated nephrolithiasis. Nephrol Dial Transplant, 1990,5(11):974-976. [12] Mohkam M, Karimi A, Gharib A, et al. Ceftriaxone associated nephrolithiasis: a prospective study in 284 children. Pediatr Nephrol, 2007,22(5):690-694. [13] Tasic V, Sofijanova A, Avramoski V. Nephrolithiasis in a child with acute pyelonephritis: Answer. Pediatr Nephrol, 2005,20(10):1510-1511,1512-1513. [14] Murata S, Aomatsu T, Yoden A, et al. Fasting and bed rest, even for a relatively short period, are risk factors for ceftriaxone-associated pseudolitiasis. Pediatr Int, 2015,57(5):942-946. [15] Stojanovic V, Djuric Vijatov G. Nephrolithiasis caused by ceftriaxone in a 3-year-old child with ureteropelvic junction obstruction. Case Rep Med, 2009,2009:365962.
