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[Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism].

AbstractINTRODUCTION:
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 importance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
AuthorsI Simon, T Roumeguère, F Devuyst, F Cotton, B-N-T Tang, M Cappello, S Corbetta, M Idrissi, A Pozdzik, J Nortier
JournalRevue medicale de Bruxelles (Rev Med Brux) 2015 May-Jun Vol. 36 Issue 3 Pg. 172-6 ISSN: 0035-3639 [Print] Belgium
Vernacular TitleNéphrolithiases récurrentes de brushite révélant une hyperparathyroïdie primaire.
PMID26372980 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Calcium Phosphates
  • calcium phosphate, dibasic, dihydrate
Topics
  • Calcium Phosphates (metabolism)
  • Diagnosis, Differential
  • Humans
  • Hyperparathyroidism, Primary (complications, diagnostic imaging, pathology)
  • Male
  • Middle Aged
  • Nephrolithiasis (complications, diagnostic imaging, metabolism, pathology)
  • Radiography
  • Recurrence

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