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Acute Hemorrhagic Cystitis(AHC) in Children -Etiology and Clinical Characteristics-

Journal of the Korean Pediatric Society 1995;38(2):207-215.
Published online February 15, 1995.
Acute Hemorrhagic Cystitis(AHC) in Children -Etiology and Clinical Characteristics-
Jin Won Pyo1, Eun Hwa Choi1, Jin Young Park1, Hoan Jong Lee1, Hae Il Cheong1, Il Soo Ha1, Yong Choi1, Kwang Myung Kim2, Hwang Choi2, Je Geun Chi3
1Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
2Department of Urology, Seoul National University, College of Medicine, Seoul, Korea
3Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea
급성 출혈성 방광염 -원인 및 임상상-
표진원1, 최은화1, 박진영1, 이환종1, 정해일1, 하일수1, 최용1, 김광명2, 최황2, 지제근3
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 비뇨기과학교실
3서울대학교 의과대학 병리학교실
: AHC characterized by sudden onset of gross hematuria, dysuria and frequency oc curs in children and young adults as a self-limited disease that should be differentiated from se rious renal disorders. We have performed this study to establish the cause and characterize the clinical features of this illness in Korean children.
: 19 cases collected prospectively for 30 month-period over 1991-1993 were reviewed. Urine specimens were obtained after normal voidings and inoculated into Hep-2 cell monolayers for virologic study, and cultured as standard method for bacteria. Isolates producing a c ytopathic effect characteristic of adenovirus were confirmed by indirect immunofluorescent staining with monoclonal antibody specific to adenovirus and also by electron microscopy. Adenoviruses were typed by hemagglutination-inhibition test by Dr. Piedra at the Texas Medical Center, USA.
: The ages of the patients were between 5 months and 14 years. Adenovirus was isolated from the urine in 8 cases(42%) and E. coli in 2(10.5%). Of 8 patients with positive culture, adenovirus type 7a was recovered in 4 cases, and adenvirus type 11 in 4 cases. Seven of th e 8 patients with positive adenovirus culture were boys while E. coli was isolated only in girls. N o sexual difference was found in cultur-negative group(M:F=4:5). The sudden onset of painful hematuria was the most impressive manifestation. Gross hematuria continued for 3 to 15(aver-age 8.9) days. Suprapubic pain was present in 4. Only one patient had mild fever. Ten of 11 ultrasonic examinatinons showed thickening of bladder wall and decreased filling capacity.
: These data suggest that culture for viruses may be useful method for differential diagnosis of AHC and adenovirus type 7a is newly identified to be one of the important causes of this illness. Further studies on ABC are needed to investigate the unexplained part of etiology.
Key Words: Acute hemorrhagic cystitis, Adenovirus, E. coli

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