An infant presenting with a non-functional kidney on dimercaptosuccinic acid scan: question

Excerpt

A 6.5-month-old girl was hospitalized because of acute pyelonephritis (APN). She was born by cesarean section to a 27-year-old mother and a 33-year-old father, at term and as the second child, after a normal pregnancy. Her weight was 3,000 g, length 49 cm and head circumference (Hc) 32 cm. She was fed breast milk, without regular formula, and had not been given milk or formula imported from other countries. Her healthy parents were third cousins. She had one sibling aged 8 years. The patient had no family history of renal tumour or of any syndrome associated with renal tumour. The paternal history was positive for several episodes of spontaneous stone passage. Analysis of a stone that her father had passed previously had shown calcium oxalate, but he was not specifically investigated. All immunizations were up to date, and growth and development were within normal ranges. Physical examination revealed unilateral strabismus. Examination by an ophthalmologist showed left esotropia. Examination of the lens, iris, and retina resulted in normal findings. The esotropia had been noted before she was 6 months old. …