Recurrence of primary hyperoxaluria after kidney transplantation.

Abstract

Primary hyperoxaluria is a genetic disorder in glyoxylate metabolism that leads to systemic overproduction of oxalate. Functional deficiency of alanine-glyoxylate aminotransferase in this disease leads to recurrent nephrolithiasis, nephrocalcinosis, systemic oxalosis, and kidney failure. We present a young woman with end-stage renal disease who received a kidney allograft and experienced early graft failure presumed to be an acute rejection. There was no improvement in kidney function, and she was required hemodialysis. Ultimately, biopsy revealed birefringent calcium oxalate crystals, which raised suspicion of primary hyperoxaluria. Further evaluations including genetic study and metabolic assay confirmed the diagnosis of primary hyperoxaluria type 1. This suggests a screening method for ruling out primary hyperoxaluria in suspected cases, especially before planning for kidney transplantation in patients with end-stage renal disease who have nephrocalcinosis, calcium oxalate calculi, or a family history of primary hyperoxaluria.

• Authors: Tahereh Malakoutian, Mojgan Asgari, Massoud Houshmand, Ronak Mohammadi, Omid Aryani, Esmaeel Mohammadi Pargoo, Ahad J Ghods
• Journal: Iranian journal of kidney diseases (Iran J Kidney Dis) Vol. 5 Issue 6 Pg. 429-33 (Nov 2011) ISSN: 1735-8604 [Electronic] Iran
• PMID: 22057078 (Publication Type: Case Reports, Journal Article)

Topics

• Biopsy
• Diagnosis, Differential
• Female
• Follow-Up Studies
• Humans
• Hyperoxaluria, Primary (diagnosis, etiology, urine)
• Kidney Failure, Chronic (surgery)
• Kidney Transplantation (adverse effects, pathology)
• Recurrence
• Young Adult