Steven Docimo, MD Executive Vice President, Business Development and Strategy | Children's Hospital of Philadelphia
Steven Docimo, MD Executive Vice President, Business Development and Strategy | Children's Hospital of Philadelphia
A 25-month-old girl with early-onset kidney stones has received successful treatment at the Children's Hospital of Philadelphia (CHOP). The patient, initially evaluated for recurrent urinary tract infections, was found to have large bilateral kidney stones. Despite undergoing six procedures, including shockwave lithotripsy and ureteroscopy, the stones persisted.
The patient's parents sought a second opinion from Dr. Gregory E. Tasian at CHOP. Dr. Tasian recommended a percutaneous nephrolithotomy (PCNL) and a right ureteroscopy to clear residual stones. The procedures were successful, and the patient was discharged two days later without further pain or infections.
Dr. Jason T. Lee noted that if the stones recur, tiopronin would be considered as part of her treatment plan. Currently, she is on potassium citrate therapy and follows a low-sodium diet with high fluid intake.
The case highlights cystinuria's challenges—a rare genetic condition leading to increased cystine excretion and stone formation—and underscores the importance of tailored treatments for such conditions.
Dr. Tasian emphasized that "children and adolescents undergoing PCNL have less pain, fewer urinary symptoms and less anxiety after surgery compared to ureteroscopy." CHOP's Pediatric Kidney Stone Center offers comprehensive care through its multidisciplinary team approach, integrating expertise from various specialists.
The center also collaborates with national networks like the Pediatric KIDney Stone Care Improvement Network to advance research in pediatric kidney stone disease.
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