Echogenic renal pyramids (differential)

Echogenic renal pyramids in children can be due to many different causes.

Differential diagnosis

Nephrocalcinosis

Iatrogenic (most common cause)

• furosemide (frusemide)
• vitamin D
• steroids

Non-iatrogenic

• idiopathic hypercalcemia
• Williams syndrome
• hyperparathyroidism
• milk-alkali syndrome
• Kenny-Caffey syndrome
• distal renal tubular acidosis
• malignant tumors
• chronic glomerulonephritis
• Sjogren syndrome (distal RTA)
• sarcoidosis

Metabolic disease

• gout
• Lesch-Nyhan syndrome (urate)
• Fanconi syndrome
• glycogen storage disease type 1A
• Wilson disease (distal RTA)
• Hurler mucopolysaccharidosis
• alpha-1 antitrypsin deficiency
• tyrosinemia
• cystinosis
• oxalosis
• Crohn disease

Hypokalemia

• primary aldosteronism
• pseudo-Bartter syndrome

Protein deposition

• infant dehydration with presumed Tamm-Horsfall proteinuria / stasis nephropathy
• toxic shock syndrome

Vascular congestion

• sickle cell anemia

Infection

• candida / cytomegalovirus (CMV) nephritis
• AIDS-associated Mycobacterium avium-intracellulare

Fibrosis of the renal pyramids 

Autosomal recessive polycystic kidney disease

Cystic medullary disease 

• medullary sponge kidney
• congenital hepatic fibrosis with tubular ectasia

Intrarenal reflux

• chronic pyelonephritis

Siehe auch:

• Uromodulin