Hello,
Thank you for your query to DoctorSpring.com
It's not easy to say that the kidney size is normal or not unless it is grossly abnormal in this age group
You don't need to worry now
There is a prominent PCS on both the sides. Though it can happen when there is full urinary bladder or otherwise due to reflux which the doctor has explained to you diagrammatically
You need to get another ultrasound only to prove and be doubly sure about the kidney size
DMSA shows the presence if scars in the kidneys due to which the size has come down but he requires DTPA renogram before to show the kidney size as well as function of kidneys . If size is less then you can check whether scars are there or not
There is no universally acceptable sizes for children which can depend on several physical factors as well
I would recommend that you can get DMSA scan and get back to me
I would appreciate if you can clarify the following details for me:
1 birth wright?
2. Any time ultrasound done before ?
3 height and weight
4. Any medical illness
5 urine infections before
6 was ultrasound done when he was in womb
Hope this helps, feel free to discuss further
Patient replied :
Dear Dr. Sree Bhushan
Here are my answers to your queries
1 birth wright?
Birth Weight was 2.6 Kg
2. Any time ultrasound done before ?
Yes Ultrasound was done before. It was done when he was about 6-7 months old. Reports were normal. I have attached the ultrasound report for your reference
3 height and weight
height - 112 cm
Weight - 19.2 Kg
Age - 6 years
4. Any medical illness
He had epileptic fits when he was a baby(Status epilepticus). He had episodes of short lasting fits(5-10 secs) till he was about 6 months old. A number of diagnostic tests were performed. Howevere no clear indicators were found as to why he was having fits. Hence the doctor concluded that it might be some genetic factor. Doctors prescribed him phenobarbitol and he was taking phenobarbitol till he was about 1 year of age. After 1 year his medication was discontinued as his EEG reports were normal and he was no longer having episodes of fits. From 1 year till now he has had no recurrence of these fits
5 urine infections before
He had a urine infection before when he was about 3 months old. The urine infection was probably due to his admission to the hospital on account of epilectic seizure. Doctors has to give a course of antibiotics to cure the infection.
6 was ultrasound done when he was in womb
Yes the ultrasound was done before when he was in the womb and the results were normal.
Hope this helps, feel free to discuss further
Hello,
As per your reports, the dilatation of PCS is of recent origin which comfortably rules out few conditions. You can definitely do DMSA and Diuretic Reno gram alternately. Children with low birth weight of less than 2.5 kg are at risk for kidney damage early in their adult life. As in-utero ( inside the womb) and later once after birth, the PCS was normal, you don't need to worry about. He must have had febrile seizures which are frequent in many children will not have any major implications in the future.
You can get back to me once those scans are done
Regards
Patient replied :
Hello
Thanks for your response. I have one more query. Since we were suggested to DMSA scan for our son, we were told that it would be done under anaesthesia since it can take 3-4 hours to complete this procedure. However we are conncerned with the use of anaesthesia since our child is still small.
1. Firstly we were told that he might face some difficulty breathing when he wakes up after the procedure and he might be required to be admitted to the ICU to help him breathe. After hearing this we are approaching this test with caution and want to do it if it is really required at this stage considering the fact that he had a history of epileptic seizures. Mainly we want to assess the side effects of anaesthesia.
2. Are there any less instrusive tests which can be considered such as the MRI/CT scan before it is assessed whether DMSA is really required.
Thanks and Best Regards
Dear Parent,
General Anesthesia is safe and can be given even to a new born in this era do modern anesthesia
He can undergo the procedure . DMSA is the gold standard and gives a major relief to you after the report . I can understand the feelings if parents when their children are undergoing such procedures . But I can assure that there won't be such a situation and he can safely go for the test
Hope this helps, feel free to discuss further