Case report: Uncommon Sulfamethoxazole crystalluria

The data contained in this article are related to the article entitled “Case report: Uncommon Sulfamethoxazole Crystalluria” (Castiglione et al., 2018). Sulfamethoxazole crystalluria is very rare and crystals identification is complex (de Liso et al., 2016). We identified seven patients with uncommon urine crystals that were composed of N-Acetyl-Sulfamethoxazole. Three of the patients developed an acute renal failure simultaneously to crystalluria. Hence, this data article describes the method of crystals identification thanks to infrared spectroscopy. The relevant clinical data of patients, including medical history, drug dosage and urine parameters related to the crystalluria are presented.

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“…Images of the crystals are available in the paper “Case report: uncommon Sulfamethoxazole crystalluria” [1] , where the data are discussed.…”

Section: Datamentioning

confidence: 99%

Clinical data on rare Sulfamethoxazole crystalluria assessed by Fourier transform infrared spectrophotometry

2018

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“…Several case studies have described the rare occurrence of urinary crystals following the administration of sulfamethoxazole in humans, either in its uncombined form or combined with trimethoprim. [38][39][40] However, sulfamethoxazole-induced crystals are described as being hexagonal in shape, as opposed to the crystal shapes observed in the chimpanzee samples. The crystals were also noted to be visible in acidic urine with a pH of <6.5, [38][39][40] in contrast to the highly basic pH noted in the samples with crystalluria in this study.…”

Section: Medicationsmentioning

confidence: 84%

“…[38][39][40] However, sulfamethoxazole-induced crystals are described as being hexagonal in shape, as opposed to the crystal shapes observed in the chimpanzee samples. The crystals were also noted to be visible in acidic urine with a pH of <6.5, [38][39][40] in contrast to the highly basic pH noted in the samples with crystalluria in this study. It is therefore highly unlikely that the administration of sulfamethoxazole-trimethoprim resulted in the calcium salt crystalluria observed in our study population.…”

Section: Medicationsmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Calcium salt crystalluria in a captive chimpanzee (Pan troglodytes) population

Fendrich¹

2023

J of Medical Primatology

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Urinalysis is a standardized method of health monitoring in captive and wild chimpanzees (Pan troglodytes), as urine collection is noninvasive in nature and provides a significant amount of information about an individual's health. [1][2][3][4] Dipstick analysis and refractometry are feasible to perform in the field; however, it is more difficult to perform a urine sediment analysis outside of a hospital setting due to the equipment required and the time limitation on analyzing the sample. For this reason, sediment analysis is often not included in papers investigating primate urine samples.Microscopic crystalluria is identified during the urine sediment analysis portion of a urinalysis. While crystalluria can be benign or normal in herbivores, 5,6 it can also indicate kidney dysfunction, pH imbalance, or various toxicities. [5][6][7] Furthermore, crystalluria can cause disease due to renal mineralization, 6,7 or result in pathological nephrolithiasis or urolithiasis. 6 Renal disease is the second most common cause of morbidity and mortality in captive chimpanzees, 8,9 surpassed only by cardiac disease. 9 Renal disease has also been linked to various cardiac pathologies in humans 9 ; therefore, it is important to note the presence of crystalluria in chimpanzees so that further exploration of renal and cardiac function can be performed.This study explores calcium salt crystalluria in a captive chimpanzee population and analyzes the differences between samples with and without crystalluria. It also discusses the possible effects of diet and various medications on the occurrence of crystalluria.

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“…SMX crystals are generally described as pleomorphic: appearance like “shocks or sheaves of wheat”, spheres, rosettes, fans and/or hexagons, among other forms, some of them very similar to those observed in this case report. Further, crystals can be yellow or brown, and by polarized light, are strongly birefringent [ 11 , 13 , 14 , 15 , 16 ]. Considering the variability of presentation of SMX crystals, and the possibility of misdiagnosis of uric acid crystals, the identification of SMX exposure is crucial for the correct diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury associated to sulfamethoxazole urine crystal: The importance of clinical suspicion

Sepúlveda¹,

Anghileri²,

E³

et al. 2022

CNCS

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Management of acute kidney injury (AKI) associated with drug-induced crystal nephropathy can be difficult, and timely diagnosis is critical to resolve this condition. We present the case of a 55-year-old woman with history of systemic lupus erythematosus (SLE), who, after treatment with trimethoprim/sulfamethoxazole (TMP/SMX) for suspected Pneumocystis jirovecii pneumonia, developed severe AKI. Automated urinary sediment initially reported hematuria, leukocyturia and “uric acid crystals”. She did not have allergic symptoms, clinical manifestations of active SLE nor hyperuricemia. AKI persisted despite volume expansion with crystalloids. Due to SMX exposure, it was suspected that “uric acid crystals” could be in reality “SMX crystals”, and were a possible cause of crystal nephropathy. TMP/SMX was withheld and urinary alkalization was performed, with subsequent resolution of AKI. SMX urine crystals were posteriorly confirmed by Fourier transform infrared spectroscopy.

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Case report: Uncommon Sulfamethoxazole crystalluria

Cited by 5 publications

References 5 publications

Clinical data on rare Sulfamethoxazole crystalluria assessed by Fourier transform infrared spectrophotometry

Clinical data on rare Sulfamethoxazole crystalluria assessed by Fourier transform infrared spectrophotometry

Calcium salt crystalluria in a captive chimpanzee (Pan troglodytes) population

Acute kidney injury associated to sulfamethoxazole urine crystal: The importance of clinical suspicion

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