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What Does My Lab Test Report Indicate?

Posted on Mon, 20 Nov 2017

Question: Hello Doctor,
My son is now 5.5 months old and he has been diagnosed with "Left Hydronephrosis". He was admitted to hospital due to fever on 8-Jul-2017 and was discharged on 13-Jul-2017 after recovery. As per doctor's prescription (dated 17-Jul-2017) we are giving him Sporidex drops every night.
The discharge summary and the prescription has been attached here for your reference.
As per the doctor's plan, MCUG test was done on 17-Jul-2017 and it showed "Grade-II VUR on left side". The report is attached for your reference.
Next, as per the doctor's plan again, today DMSA test is done and the reports are attached for your reference.
Kindly help us with the below queries:
1. What does the DMSA report signify? Is there something which we should worry about?
2. Is the current ongoing treatment correct?
3. The test done today is with radioactive material, is there some precaution which we should be taking?
4. Is this problem recoverable?
We are really concerned about the baby's health doctor, we want the baby to recover and be healthy. Kindly help us with our concerns.
Thanks,
xxx XXXXXXX x

Answered by Dr. Dr. P. T. Patil (36 minutes later)

Brief Answer:
The treatment suggested is on proper line

Detailed Answer:
Hello
Thanks for query
Your son has been diagnosed to have Grade 2 V U R .causing reflux of urine back in to kidney leading to infection and thereby damaging his left kidney

In most of the cases of grade 2 VUR T the VUR recovers as the child grows up improving the kidney function
Answers to your questions are
1) You need not worry about the nuclear medicine
2) The VUR gets corrected and there are every chances of recoverywithin 3_4 years

One has to continue antibiotic as per advice of paediatrician and get routine urine tests done periodically and take care that child does not develop UTI.

Thanks and Regards
Dr Patil

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. P. T. Patil (23 hours later)

Thank you doctor for your diagnosis. This has instilled some confidence in us!

We have read online that the Kidney functionality which has reduced will never improve back. Is this true? Is there any treatment to get his kidney back to full functionality.

Thank you doctor!

- xxx XXXXXXX x

Answered by Dr. Dr. P. T. Patil (24 hours later)

Brief Answer:
There is every chance of improving kidney function

Detailed Answer:
Hello,

Thanks for following up,

In pediatric age group, there is every chance of improvement as far as the kidney is concerned.

Though not 100% even 50% improvement is acceptable.

Thanks and Regards
Dr.Patil

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. P. T. Patil (33 hours later)

Hello doctor,

Thank you for your reply. I still have one doubt though. My kid was diagnosed that he has a bulge and Hydronephrosis condition existed in pre-natal scan itself. In such conditions, why didnt the doctors take precaution and prescribe the same 'Sporidex' drops to tackle any possible cases of infection right since birth instead of prescribing it now after the infection was detected and treated

Thanks,
xxx XXXXXXXx?

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
Child develops infection after birth

Detailed Answer:
Hello Patil l
Thanks for follow up
Child does not develop infection during intra uterine life hence no antibiotic is prescribed during pregnancy.

Thanks and Regards
Dr Patil

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. P. T. Patil (15 minutes later)

Not during pregnancy doctor, but the Sporidex medicine could have been prescribed after the birth, isnt it?

Answered by Dr. Dr. P. T. Patil (16 minutes later)

Brief Answer:
Antibiotics are to be processed very coutiously

Detailed Answer:
Hello
Thanks for follow up
In infamy antibiotics are to be prescribed very cautiooutiously and only in a situation when it is absolutely indicated
Thanks and Regards
Dr Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (38 minutes later)

Thabk you very much for clearing my doubts doctor. Does this means that there are any ill effects of the Anti-biotics on the baby in near or long term?

Please guide us how we need to be prepared for future so that as parents we can take good care of him and give him a good future.

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
Antibiotic that is prescribed is in very small dose

Detailed Answer:
Hello
Thanks for follow up
The antibiotic that is prescribed is in in very
small doses which has no adverse effects on baby.

Yo have to ensure that child does not get UTI . Get his routine urine tests done periodically. In case he gets fever get his urine culture done and change the antibiotic as per culture report.

This has to be followed religiously for 3-4 years . In most of the cases VUR subsides by the time child becomes 4 years old

Thanks and Regards
Dr Patil

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Above answer was peer-reviewed by : Dr. Vishesh Rohatgi