Introduction : Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). Case report : We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. Discussion : PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. Conclusion : The present case stresses the impor tance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
Néphrolithiases récurrentes de brushite révélant une hyperparathyroïdie primaire = Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism / I. Simon, T. Roumeguère, F. Devuyst, F. Cotton, B. Tang, M. Cappello, S. Corbetta, M. Idrissi, A. Pozdzik, J. Nortier. - In: REVUE MEDICALE DE BRUXELLES. - ISSN 0035-3639. - 36:3(2015), pp. 172-176.
Néphrolithiases récurrentes de brushite révélant une hyperparathyroïdie primaire = Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism
S. Corbetta;
2015
Abstract
Introduction : Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). Case report : We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. Discussion : PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. Conclusion : The present case stresses the impor tance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.Pubblicazioni consigliate
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