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Transient Neonatal Renal Medullary Hyperechogenicity
Arthur B. Meyers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Transient renal medullary hyperechogenicity
              • Descriptive term used in recent literature because etiology is unknown
            • Tamm-Horsfall proteinuria (THP)
              • Older term devised because of theory that THP precipitates in renal tubules → transient ↑ echogenicity
              • Theory has not been substantiated
          • Definitions

            • Temporary sonographic appearance of hyperechoic renal medullary pyramids in some normal neonates
            • Etiology is unclear (not linked to THP)

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Walawender L et al: Diagnosis and imaging of neonatal UTIs. Pediatr Neonatol. 61(2):195-200, 2020
                            2. Hemachandar R et al: Transient renal medullary hyperechogenicity in a term neonate. BMJ Case Rep. 2015, 2015
                            3. Maruyama H et al: Nephrocalcinosis and placental findings in neonatal bartter syndrome. AJP Rep. 3(1):21-4, 2013
                            4. Daneman A et al: Renal pyramids: focused sonography of normal and pathologic processes. Radiographics. 30(5):1287-307, 2010
                            5. Elsaify WM: Neonatal renal vein thrombosis: grey-scale and Doppler ultrasonic features. Abdom Imaging. 34(3):413-8, 2009
                            6. Makhoul IR et al: Neonatal transient renal failure with renal medullary hyperechogenicity: clinical and laboratory features. Pediatr Nephrol. 20(7):904-9, 2005
                            7. Ali US et al: Reversible renal medullary hyperechogenicity in neonatal hypernatremic dehydration. Pediatr Nephrol. 19(9):1050-2, 2004
                            8. Khoory BJ et al: Transient hyperechogenicity of the renal medullary pyramids: incidence in the healthy term newborn. Am J Perinatol. 16(9):463-8, 1999
                            9. Nakamura M et al: Hyperechoic renal papillae as a physiological finding in neonates. Clin Radiol. 54(4):233-6, 1999
                            10. Riebel TW et al: Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is it a normal phenomenon and what are the causes? J Clin Ultrasound. 21(1):25-31, 1993
                            11. Hernanz-Schulman M: Hyperechoic renal medullary pyramids in infants and children. Radiology. 181(1):9-11, 1991
                            12. Shultz PK et al: Hyperechoic renal medullary pyramids in infants and children. Radiology. 181(1):163-7, 1991
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Clinical Issues

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Synonyms

                                      • Transient renal medullary hyperechogenicity
                                        • Descriptive term used in recent literature because etiology is unknown
                                      • Tamm-Horsfall proteinuria (THP)
                                        • Older term devised because of theory that THP precipitates in renal tubules → transient ↑ echogenicity
                                        • Theory has not been substantiated
                                    • Definitions

                                      • Temporary sonographic appearance of hyperechoic renal medullary pyramids in some normal neonates
                                      • Etiology is unclear (not linked to THP)

                                    IMAGING

                                    • General Features

                                      • Ultrasonographic Findings

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Walawender L et al: Diagnosis and imaging of neonatal UTIs. Pediatr Neonatol. 61(2):195-200, 2020
                                                      2. Hemachandar R et al: Transient renal medullary hyperechogenicity in a term neonate. BMJ Case Rep. 2015, 2015
                                                      3. Maruyama H et al: Nephrocalcinosis and placental findings in neonatal bartter syndrome. AJP Rep. 3(1):21-4, 2013
                                                      4. Daneman A et al: Renal pyramids: focused sonography of normal and pathologic processes. Radiographics. 30(5):1287-307, 2010
                                                      5. Elsaify WM: Neonatal renal vein thrombosis: grey-scale and Doppler ultrasonic features. Abdom Imaging. 34(3):413-8, 2009
                                                      6. Makhoul IR et al: Neonatal transient renal failure with renal medullary hyperechogenicity: clinical and laboratory features. Pediatr Nephrol. 20(7):904-9, 2005
                                                      7. Ali US et al: Reversible renal medullary hyperechogenicity in neonatal hypernatremic dehydration. Pediatr Nephrol. 19(9):1050-2, 2004
                                                      8. Khoory BJ et al: Transient hyperechogenicity of the renal medullary pyramids: incidence in the healthy term newborn. Am J Perinatol. 16(9):463-8, 1999
                                                      9. Nakamura M et al: Hyperechoic renal papillae as a physiological finding in neonates. Clin Radiol. 54(4):233-6, 1999
                                                      10. Riebel TW et al: Transient renal medullary hyperechogenicity in ultrasound studies of neonates: is it a normal phenomenon and what are the causes? J Clin Ultrasound. 21(1):25-31, 1993
                                                      11. Hernanz-Schulman M: Hyperechoic renal medullary pyramids in infants and children. Radiology. 181(1):9-11, 1991
                                                      12. Shultz PK et al: Hyperechoic renal medullary pyramids in infants and children. Radiology. 181(1):163-7, 1991