Secondary enuresis and urological manifestations in children with ataxia telangiectasia

Andreea Nissenkorn*, Tomer Erlich, Dorit E. Zilberman, Ifat Sarouk, Alexander Krauthammer, Noam D. Kitrey, Gali Heimer, Bruria BenZeev, Yoram Mor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ataxia telangiectasia (AT) is a neurodegenerative cerebellar disorder, caused by mutations in the ATM gene, involved in DNA repair. Radiosensitivity, progressive ataxia, immune deficiency and malignancies, are well known symptoms, but urological manifestations are scarcely described. Objective: To characterize urologic manifestations in a large cohort of AT patients. Methods: Retrospective cross-sectional chart study comprising 52 AT patients followed at a National AT Center. Results: 25% of the cohort (13 patients/8 males) had urologic symptoms, which presented at 11 ± 4.3 years. The most common symptom was secondary enuresis affecting 15% of the patients (8 children/4 males). Incontinence appeared at 8 ± 6.2 years of age, and resolved spontaneously within 15 ± 8.3 months in 6 patients. It preceded loss of ambulatory capacity by 1–2 years in 7 patients. Lumbosacral MRI were normal (4 children) and urine cultures (all) were negative. Urodynamic evaluation that was performed in only one patient revealed overactive bladder. Additional manifestations were macroscopic hematuria due to bladder telangiectasia in a 12-year-old, and renal cell carcinoma in a 22-year-old. Other manifestations unrelated to AT were neprolithiasis, vesico-ureteral reflux and scrotal pain, each in 1 patient. Discussion: Transient secondary enuresis is a frequent finding in AT patients, heralding loss of ambulatory capacity, tough it's pathophysiological mechanism is largely no understood.

Original languageEnglish
Pages (from-to)1118-1123
Number of pages6
JournalEuropean Journal of Paediatric Neurology
Volume22
Issue number6
DOIs
StatePublished - Nov 2018

Keywords

  • ATM
  • Ataxia telangiectasia
  • Incontinence
  • Neurogenic bladder
  • Urinary tract

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