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      Effect of hydrochlorothiazide on reducing recurrent abdominal pain in girls with idiopathic hypercalciuria

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          Abstract

          BACKGROUND:

          This study assessed the possible effect of hydrochlorothiazide (HCT) on soothing recurrent abdominal pain (RAP).

          METHODS:

          A hundred girls with RAP and IH were randomly assigned into two groups of experiment (treated with hydrochlorothiazide 1mg/kg/day) and control and all patients were followed for 3 months.

          RESULTS:

          In the experiment group, the mean of painful attacks in the first, second and third month were 0.38, 0.4 and 0.26, respectively which were far less than their counterparts in the control group.

          CONCLUSIONS:

          Single daily dose of HCT is a safe and effective therapeutic option in the treatment of RAP in children with IH.

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          Most cited references11

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          Clinical presentation and natural course of idiopathic hypercalciuria in children.

          A Manna, F Cioce, R. Camacho Toro … (2000)
          Idiopathic hypercalciuria (IHC) has been reported mainly in children with hematuria in the 1980s and early 1990s, when renal sonography was just becoming routine. The presence of microcalculi, i.e., of hyperechogenic spots or = 1 years (mean 3.2) with no specific therapy. At diagnosis, 38 patients (51%) had no hematuria, 42 (57%) had microcalculi and four (5%) had calculi. Of the patients with normal urinalysis, 71% had microcalculi or stones. The subjects with microcalculi and those with stones were significantly older than those without microcalculi and stones (P = 0.004 and 0.007). A normal urinalysis at our evaluation and a history of abdominal/flank pain were significantly more frequent in patients with microcalculi than in those without (P = 0.02 and 0.0001, respectively). During the follow-up, four of 30 patients formed stones 1-3 years after first diagnosis of IHC. More than half of children with IHC have microcalculi. The risk of formation of microcalculi or stones increases with age. The lack of hematuria does not exclude the presence of microcalculi or calculi. Hypercalciuria has to be suspected in children with dysuria and/or recurrent abdominal flank pain and a family history of nephrolithiasis, even when they have no hematuria.
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            Diuretics

            EK Jackson (1996)
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              Recurrent abdominal and flank pain in children with idiopathic hypercalciuria.

              María M. Malagón, P Vachvanichsanong, Sophie E. Moore (2001)
              To evaluate the role of idiopathic hypercalciuria (IH) as a cause of recurrent abdominal pain (RAP) in children. We retrospectively reviewed the medical records of 124 children referred for various complaints who had 24-h urine calcium excretion greater than 2 mg/kg/d or random urine calcium-creatinine ratio greater than 0.18 mg/mg. Fifty-two children with various clinical complaints had RAP or flank pain. These comprised of 22 males and 30 females, 9 mo to 15.9 y of age, mean 6.7 +/- 3.5 y. A family history of urolithiasis was present in 50% of all the children. Only 6 of the 52 children with abdominal pain had renal stones. In addition to abdominal pain, 27 children had hematuria and 10 had urinary incontinence. Mild metabolic acidosis was present in three children, parathyroid hormone activity elevated in two and serum vitamin D activity was increased in nine. All children were treated with increased fluid intake and a reduction in dietary sodium and oxalate and some required treatment with thiazide and antispasmodics. Forty-five cases responded to treatment, 5 failed to improve from therapy, and 2, which were not followed up as patients, were not available. We describe 52 children with RAP or back pain due to IH and recommend that IH be considered in the differential diagnosis of RAP in childhood.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Res Med Sci
                Journal ID (publisher-id): JRMS
                Title: Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 1735-1995
                ISSN (Electronic): 1735-7136
                Publication date (Print): March 2011
                Volume: 16
                Issue: Suppl1
                Pages: S433-S436
                Affiliations
                [a ] Assistant Professor, Department of Pediatrics, Arak University of Medical Science, Arak, Iran.
                [b ] Assistant Professor, Department of Urology, Arak University of Medical Science, Arak, Iran.
                [c ] MSc Student in Midwifery, Shahid Beheshti University of Medical Sciences, Arak, Iran.
                [d ] Specialist of Nuclear Medicine, Arak, Iran.
                Author notes
                [* ] Corresponding Author E-mail: parsayousefichaijan@ 123456yahoo.com
                Article
                Publisher ID: JRMS-16-433
                PMC ID: 3252778
                PubMed ID: 22247730
                SO-VID: e31af7c6-6df3-4d61-a5c1-ccdf7f614d95
                Copyright © Copyright: © Journal of Research in Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 January 2011
                Date accepted : 02 April 2011
                Categories
                Subject: Short Communication

                ScienceOpen disciplines: Medicine
                Keywords: child,abdominal pain,hypercalciuria,recurrence,hydrochlorothiazide
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: child, abdominal pain, hypercalciuria, recurrence, hydrochlorothiazide

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