KCH Lau, LMF Tee, EYL Kan, CY Lui, GKF Tam, KP Fung, WCW Wong, HS Lam

Abstract

To evaluate renal ultrasound findings related to melamine-tainted milk products. Between 26th September 2008 to 28th November 2008, 1,872 children aged 12 years or younger who had consumed melamine tainted milk products (MTMP) for more than one month were referred to our special assessment centre for renal ultrasound and urinalysis. Five children were found to have MTMP associated stones, which fulfilled the criteria: strong echogenic lesion ≥4 mm lying inside the collecting system or an ultrasonographic abnormality not completely fulfilling the aforementioned criteria with dilatation of either renal pelvis or renal calyx. Four children were found to have MTMP associated deposits, these were renal hyperechoic foci that did fulfill the stone criteria but were persistent on follow-up scans. Two children found to have MTMP suspected renal deposits, which were defined as renal hyperechoic foci that were not detectable on follow-up scan. Incidence rates of renal stones, renal deposits and suspected renal deposits are 0.27%, 0.21% and 0.11%, respectively. A similar study performed by Peking University of children up to three years of age who were exposed to MTMP showed a higher incidence of renal stones/deposits, which could be due to consumption of higher concentration of melamine tainted milk products and the large quantity of milk consumed in this younger age group. Melamine coalesces with other milk related products to form crystals that block tubules of the kidney. Little is known about the effects of melamine in humans. This study evaluates the spectrum and short term changes of ultrasound findings related to MTMP. Further evaluation and follow-up of these children shown to be affected by melamine may be useful in assessing the long term sequelae.

旨在評估三聚氰胺污染的牛奶產品與腎臟超聲檢查結果的關係。在2008年9月26日至2008年11月28日，共1872名年齡在12歲或以下的兒童曾飲用受「三聚氰胺」污染的奶類製品（MTMP）超過1個月，皆被轉介到我們特設的腎臟超聲檢查和尿檢評估中心。五名孩子被發現有MTMP相關的結石，符合收集系統內強迴聲病變≥4毫米或不完全符合上述標準，但出現腎盂或腎盞擴張的超聲檢查結果。四名孩子被發現有MTMP相關的沉積物，都是腎臟迴聲竈乎合診斷標準的，但在後續掃描持續出現。按腎迴聲竈定義，兩名孩子有疑似腎沉積物，但後續的掃描再沒有出現。腎結石、腎沉積物和疑似腎沉積物的發生率分別為0.27％、0.21％和0.11％。北京大學進行了類似的研究，他們報導3歲或以下的兒童食用受三聚氰胺污染的奶類製品後，會有較高機會出現腎結石/沉積物，這可能是由於飲用高濃度三聚氰胺污染的奶類製品和這個年輕的年齡組大量飲用牛奶有關。三聚氰胺與其他奶類相關產品在腎小管內凝聚成結晶並發生阻塞。三聚氰胺在人體的影響，我們知之甚少。本研究旨在探討超聲檢查與食用受三聚氰胺污染的奶類製品後的頻譜和短期變化。進一步的評估和隨訪受三聚氰胺影響的兒童，可能對評估長期後遺症有重要價值。