| Objective To investigate the clinical feature of the urolithiasis in infants who were fed with melamine contaminated milk powder and the short-time impact of growth and development and the urinary system in children with the consumption of melamine-contaminated milk. Materials The clinical data of 165 infants with urinary calculus who had the history of feeding melamine contaminated milk powder were analyzed. According to the "treatment program" issued by the Ministry of Health, children were divided into:mild group (25 cases), moderate group (122 cases), moderate and severe group (18 cases). And 30 cases of hospitalized children in the same period without the feeding history of melamine-contaminated milk powder and excluding children with urinary tract diseases was selected as the normal control group of blood and urine analysis examination. Another 10 cases of urinary stone in children, with pure breast-feeding or without the feeding history of melamine-contaminated milk, was served as the stone control group. Meanwhile, 200 cases of normal children without melamine-tainted milk feeding history was collected as the follow-up control group. Methods This study retrospectively analyzed 165 cases clinical data. Through telephone and by letter, etc, the 165 cases of children and the control group infants were followed up for 1-year follow-up by professional doctors. The relevant parameters of different groups were compared. Results Eighty point six percent cases (138/165) occurred at the age under 2 year-old,41.2%(68/165) of them aged 6m-12m. The male and female ratio in the 165 cases was 2.6:1. Half of cases (49.7%) presented different clinical symtoms, dysuria 16.9%, infantile colic 14.6%, oliguria or anuria 10.9% and hematuria 7.3%. The diameter of calculi ranged from 2mm to 16mm,63.5% of them 4-10 mm. After (9±5) d hospitalization treatment 43% cases get stone free. The comparison between the MUS group and the control group showed that the difference of urine pH was statistically significant (P<0.05), significantly lower than normal. The BUN, Scr, SUA of the severe group compared with the mild group, moderate group and the control group were significantly increased. The stones of the MUS group were significantly smaller than stones of the control group, and in the MUS group, the incidence of multiple stones, sand-like stones was higher than that in the shone control group. After (9±5) days of hospitalization, in all of 165 cases of children, the clinical symptoms had disappeared, with no deaths. In 71 cases stones completely disappeared, stones of 67 patients were smaller, and in 27 patients stones had no significant change. In all patients with renal failure, renal function was restored. One hundred and forty cases of hospitalized children including 90 cases with stones were successfully followed up. There was no urinary space-occupying lesion, and urine, blood and kidney function tests were normal. In the follow-up, stones disappeared in 83 cases, stones of 4 cases were smaller,1 case had no significant change, and 1 stone increased. Radioparent calculus of 3 cases transformed radiopaque calculus; 29 cases hydronephrosis disappeared,4 cases got mitigation. The number of children with low height in MUS group was significantly higher than the control (p<0.05), there was no significant difference that body weight in MUS group compared with that of the control (p> 0.05). Conclusions The melamine calculus occurred mostly likely in infants when fedding melamine contaminated milk powder over 6 months. Multiple stone was most frequently confronted and noninvasive management could get a good response. Follow-up study showed that children with melamine stones mostly had recovery in half year. Hydronephrosis gradually disappears with the discharge of stone. During 1 year follow-up there was no urinary tract tumor. Growth and development of the children with the history of consumption of melamine-contaminated milk was almost normal. |
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