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Gouty Diathesis and Sarcoidosis in Patient with Recurrent Calcium Nephrolithiasis

1988; Lippincott Williams & Wilkins; Volume: 139; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)42895-3

1527-3792

Jean A. Harvey, Charles Y.C. Pak,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyCase Reports1 Jun 1988Gouty Diathesis and Sarcoidosis in Patient with Recurrent Calcium Nephrolithiasis Jean A. Harvey, and Charles Y.C. Pak Jean A. HarveyJean A. Harvey More articles by this author , and Charles Y.C. PakCharles Y.C. Pak More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)42895-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Abstract: We describe a patient who initially formed calcium-containing renal stones owing to gouty diathesis and hypocitraturia. On therapy with 300 mg, allopurinol and 60mEq. potassium citrate daily serum uric acid decreased from 9.2 to 5.8 mg. per dl., urinary pH increased from less than 5.5 to 6.6 and urinary citrate increased from 223 to 1,005 mg. per day. Four months later while still on this medical regimen, the patient presented with hypercalcemia (13.4 mg. per dl.), high serum 1,25-dihydroxyvitamin D (65 pg. per ml.) and hypercalciuria (598 mg. per day), which subsequently were found to result from sarcoidosis. Prednisone therapy normalized the disturbances in calcium metabolism. During 33 months of combined treatment with 7.5 to 10 mg. prednisone a day, allopurinol and potassium citrate, the patient was free of stones and he had normal urinary calcium, pH and citrate. However, a calcium stone formed 1 month after discontinuation of prednisone therapy, although treatment with allopurinol and potassium citrate was continued. The patient had marked hypercalciuria of 447 to 465 mg. per day, despite normal urinary pH, citrate and uric acid. This case represents calcium stone formation in a patient with 2 separate etiologies for stone disease, that is gouty diathesis and sarcoidosis. Therapeutic regimens directed at the correction of both metabolic disturbances were required to control renal stone formation. © 1988 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByPak C (2018) Medical Stone Management: 35 Years of AdvancesJournal of Urology, VOL. 180, NO. 3, (813-819), Online publication date: 1-Sep-2008.Khatchadourian J, Preminger G, Whitson P, Adams-Huet B and Pak C (2018) Clinical and Biochemical Presentation of Gouty Diathesis: Comparison of Uric Acid Versus Pure Calcium Stone FormationJournal of Urology, VOL. 154, NO. 5, (1665-1669), Online publication date: 1-Nov-1995. Volume 139Issue 6June 1988Page: 1287-1289 Advertisement Copyright & Permissions© 1988 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Jean A. Harvey More articles by this author Charles Y.C. Pak More articles by this author Expand All Advertisement PDF DownloadLoading ...