trimethoprim--sulfamethoxazole-drug-combination and Dysgammaglobulinemia

A case of malacoplakia involving the lower urinary tract of a young black boy, with associated bilateral vesicoureteral reflux, hydronephrosis and selective immunoglobulin A deficiency is reported. Reflux was caused by the malacoplakia. Reflux and hydronephrosis persisted despite elimination of bacterial infection and malacoplakia by drug therapy. These abnormalities were corrected by a conventional antireflux operation. Malacoplakia appears to be related to immunologic incompetence and diminished levels of intracellular cyclic 3',5' guanine monophosphate. Cholinergic agonists reverse or prevent the pathological changes of malacoplakia.

Topics: Anti-Infective Agents, Urinary; Bethanechol; Bethanechol Compounds; Child, Preschool; Drug Combinations; Dysgammaglobulinemia; Humans; Hydronephrosis; IgA Deficiency; Malacoplakia; Male; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder; Urinary Bladder Diseases; Vesico-Ureteral Reflux