All issues > Volume 38(2); 1995

Original Article

J Korean Pediatr Soc. 1995;38(2):207-215. Published online February 15, 1995.

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

Jin Won JW Pyo¹, Eun Hwa EH Choi¹, Jin Young JY Park¹, Hoan Jong HJ Lee¹, Hae Il HI Cheong¹, Il Soo IS Ha¹, Yong Y Choi¹, Kwang Myung KM Kim², Hwang H Choi², Je Geun JG 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

Abstract

Purpose
: 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.
Methods
: 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.
Results
: 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.
Conclusion
: 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.

Keywords :Acute hemorrhagic cystitis, Adenovirus, E. coli