Recurrent abdominal and flank pain in children with idiopathic hypercalciuria

Objective: To evaluate the role of idiopathic hypercalciuria (IH) as a caus e of recurrent abdominal pain (RAP) in children. Patients and methods: We r etrospectively reviewed the medical records of 124 children referred for va rious complaints who had 24-h urine calcium excretion greater than 2 mg/kg/ d or random urine calcium-creatinine ratio greater than 0.18 mg/mg. Results : Fifty-two children with various clinical complaints had RAP or flank pain . These comprised of 22 males and 30 females, 9 mo to 15.9 y of age, mean 6 .7 +/- 3.5 y. A family history of urolithiasis was present in 50% of all th e children. Only 6 of the 52 children with abdominal pain had renal stones. In addition to abdominal pain, 27 children had hematuria and 10 had urinar y incontinence. Mild metabolic acidosis was present in three children, para thyroid hormone activity elevated in two and serum Vitamin D activity was i ncreased in nine. All children were treated with increased fluid intake and a reduction in dietary sodium and oxalate and some required treatment with thiazide and antispasmodics. Forty-five cases responded to treatment, 5 fa iled to improve from therapy, and 2, which were not followed up as patients , were not available. Conclusion: We describe 52 children with RAP or back pain due to IH and rec ommend that IH be considered in the differential diagnosis of RAP in childh ood.