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20 April 2009

Melamine in milk

The recent epidemic of urinary tract stones in young children in China has been formally linked to melamine contamination of infant formula, according to the results of a clinical study. Over 500 children aged 36 months or younger were screened in the study, which set out to determine the level of exposure to melamine, and symptoms of and predisposing factors for urinary tract stones. Clinical tests included urinalysis, tests for glomerular dysfunction, ultrasound, and biochemical markers. High melamine content in formula was significantly associated with urolithiasis — children fed high-melamine formula were seven times more likely to develop stones than those fed no-melamine formula. Most children with melamine-associated urinary stones did not have classic symptoms and signs, such as haematuria and white cells in urine. The authors advise that screening for urolithiasis should be based on the history of exposure to melamine, as symptoms may be non-specific or absent.

N Engl J Med 2009; 360: 1067-1074

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©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377