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Dr. Andrew Rynne

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Could yellowish tinge in skin be related to Vesicoureteral reflux (VUR)?

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Dr. Varanasi Pundarikaksha

Pediatrician

Practicing since :1971

Answered : 219 Questions

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Posted on Wed, 11 Dec 2013 in Child Health
Question: hi, I have a 7 month old baby boy. he was born with sepsis for which he was treated with iv antibiotics, cause of sepsis was not established. at around 8 weeks he began to slow in his weight gain and feeding ( exclusively breastfed) became poor, was admitted to hospital age 4mths weighing 10lbs (born at 8lbs 5 oz). in hospital it was suggested he was cows milk protein intolerant as his skin would blotch when fed and also he had severe reflux. also it was established that he had a uti and a tongue tie. treated with antibiotics and tongue tie was snipped a month later. 3 months on weight gain is now much improved, I am continuing to breastfeed and follow a dairy free diet, my son has started some soilids, mainly fruit and vegetables. on follow up appointment to consultant, he suggested that my son should have further testing to see if there is any kidney scarring caused by uti, and if he has VUR. my son has always appeared to me to have a very yellowish tinge to his skin, he did have raised ALT levels in LFT's, these are now considered to be normal, my query is could this yellowish tinge be related to VUR, and what is the likelihood of my son having VUR? he does not have very many really wet nappies. he appears otherwise well, but does sllep considerably more than my other two children did at this age, 11 hours at night and 3 naps during the day varying between 1 and 2 hours. many thanks XXXXXXX
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Answered by Dr. Varanasi Pundarikaksha 33 minutes later
Brief Answer: Hi, Detailed Answer: Thank you for your interest to clear your doubt through XXXXXXX Your son had Neonatal sepsis which was treated and subsequently UTI and Tongue tie with cow's milk intolerence and GER which were managed appropriately. The cause of the UTI may be evaluated as, if it is treatable, it should be managed appropriately,other wise it may lead to recurrence and chronicity causing effects on the kidneys with sequelae and finally CRF. The next test will be an ultrasonogram of the kidney, ureter, bladder. This investigation is needed to establish the diagnosis of VUR. You have also indicated about yellowish discoloration of your son and increase in ALT. It should be investigated to find out the cause of Jaundice with appropriate tests so that it is managed in a correct way. The yellowish tinge is not related to VUR. Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Varanasi Pundarikaksha 23 hours later
Many thanks for your reply, I forgot to add in my original question that my son has already had the ultra sound scan of kidneys, bladder and ureter, the results of this scan were clear with no abnormalities detected. the net tests I believe involve radioactive XXXXXXX test and a catheter test? are these routinely performed in the case of a uti and can they show up problems which the ultrasound does not pick up? The last blood LFT came back as normal, however as previously mentioned my son does still appear to have yellowish skin, but there are no further investigations planned for this. I also forgot to mention that his head circumference has gone up two centiles in 3 months, the consultant has said they will perform a head scan, what can they tell from this scan? many thanks
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Answered by Dr. Varanasi Pundarikaksha 2 days later
It seems the ultrasound scan of kidneys, ureter and bladder is normal. The special tests are not done routinely unless specifically indicated and definitely these tests give the information which the ultra sound scan does not give. The yellowish skin,what you mentioned may or may not be due to jaundice. This should be verified by a Pediatrician. You said that the head circumference has gone up and to find out the cause I would first do neurosonogram through Anterior fontanelle. If necessary CT scan may be performed. Any way CT scan would figure out if there is a structural problem, if the CSF is flowing normally and other important structural aspects. Hope this answers your queries. Regards
Above answer was peer-reviewed by : Dr. Prasad
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