Nephrocalcinosis in a patient with Sjögren's syndrome/systemic lupus erythematosus

Zanuto, Amanda Carolina Damasceno; Bueno, Tatiara; Delfino, Vinicius Daher Alvavares; Mocelin, Altair Jacob

doi:10.1590/s0104-42302012000300004

Cited by 4 publications

(5 citation statements)

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“…Measures are also taken to reduce calciuria and increase inhibitors of urinary crystallization [3-5]. However, these measures were not possible in the two cases we report, owing to the advanced degree of kidney impairment.…”

Section: Discussionmentioning

confidence: 98%

“…Nephrocalcinosis can be detected using imaging examinations such as radiography, ultrasound or computed tomography [2,3]. Axial computed tomography without contrast is considered adequate for differentiating cortical and medullary nephrocalcinosis and demonstrating the relationship between calcifications in the parenchyma and the calyceal system, allowing the precise localization of the calcifications [5].…”

Section: Discussionmentioning

confidence: 99%

“…The condition can progress to chronic kidney failure, and the prognosis depends on the underlying cause. Laboratory examinations may reveal erythrocytosis, and microscopic pyuria in the urinary sediment is nearly a constant, even in the absence of urinary infection, causing a chronic inflammatory response stemming from calcification [2,3]. …”

Section: Introductionmentioning

confidence: 99%

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Familial mixed nephrocalcinosis as a cause of chronic kidney failure: two case reports

et al. 2014

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IntroductionNephrocalcinosis consists of the deposition of calcium salts in the renal parenchyma and is considered the mixed form when it involves the renal cortex and medulla. The main etiological agents of this condition are primary hyperparathyroidism, renal tubular acidosis, medullary sponge kidney, hyperoxaluria and taking certain drugs. These factors can lead to hypercalcemia and/or hypercalciuria, which can give rise to nephrocalcinosis.Case presentationsPatient 1 was a 48-year-old Caucasian woman with a history of bilateral nephrocalcinosis causing chronic kidney failure. Imaging examinations (X-ray, ultrasound and computed tomography of the abdomen) revealed extensive calcium deposits in the renal parenchyma, indicating nephrocalcinosis as the causal factor of the disease. Patient 2 is the 45-year-old brother of patient 1. He exhibited an advanced stage of chronic kidney failure. As nephrocalcinosis is considered to have a genetic component, a family investigation revealed this condition in patient 2.ConclusionNephrocalcinosis may be detected incidentally through diagnostic imaging studies. Whenever possible, treatment should include the base disease that caused the appearance of the calcification, as the precise etiological determination is extremely important.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Familial mixed nephrocalcinosis as a cause of chronic kidney failure: two case reports

et al. 2014

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“…The unifying feature in all cases is renal tubular acidosis. Some cases have noted coexistence with other rheumatologic diseases such as lupus [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…The types of stones can be calcium oxalate, uric acid or mixed stones. In IBD, hypercalciuria itself is rare, unless an underlying genetic defect or in cases of excess Vitamin D repletion [ 37 ]. Risk factors for kidney stone formation in Crohn’s disease include the following: (1) malabsorption of fatty acids/bile salts.…”

Section: Discussionmentioning

confidence: 99%

Case report: disease mechanisms and medical management of calcium nephrolithiasis in rheumatologic diseases

et al. 2023

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Background Nephrolithiasis as a feature of rheumatologic diseases is under recognized. Understanding presenting features, diagnostic testing is crucial to proper management. Case presentation A 32 year old woman with a history of recurrent complicated nephrolithiasis presented to a rheumatologist for a several month history of fatigue, dry eyes, dry mouth, arthralgias. She had a positive double-stranded DNA, positive SSA and SSB antibodies. She was diagnosed with Systemic Lupus erythematosus (SLE) and Sjogren's syndrome and was started on mycophenalate mofetil. Of relevance was a visit to her local emergency room 4 years earlier with profound weakness with unexplained marked hypokalemia and a non-anion gap metabolic acidosis. Approximately one year after that episode she developed flank pain and nephrocalcinosis. She had multiple issues over the ensuing years with stones and infections on both sides. Interventions included extracorporeal shockwave lithotripsy as well as open lithotomy and eventual auto-transplantation of left kidney for recurrent ureteric stenosis. 24 h stone profile revealed marked hypocitraturia, normal urine calcium, normal urine oxalate and uric acid. She was treated with potassium citrate. Mycophenolate was eventually stopped due to recurrent urinary tract infections and she was started on Belimumab. Because of recurrent SLE flares, treatment was changed to Rituximab (every 6 months) with clinical and serologic improvement. Her kidney stone frequency gradually improved and no further interventions needed although she continued to require citrate repletion for hypocitraturia. Conclusions Nephrolithiasis can be a prominent and even presenting feature in Sjogrens syndrome as well as other rheumatologic diseases. Prompt recognition and understanding disease mechanisms is important for best therapeutic interventions for kidney stone prevention as well as treatment of underlying bone mineral disease.

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Nefrocalcinosis en una paciente con artritis reumatoide y síndrome de Sjögren secundario

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Montero

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2019

Reumatología Clínica

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Nephrocalcinosis in a patient with Sjögren's syndrome/systemic lupus erythematosus

Cited by 4 publications

References 5 publications

Familial mixed nephrocalcinosis as a cause of chronic kidney failure: two case reports

Familial mixed nephrocalcinosis as a cause of chronic kidney failure: two case reports

Case report: disease mechanisms and medical management of calcium nephrolithiasis in rheumatologic diseases

Nefrocalcinosis en una paciente con artritis reumatoide y síndrome de Sjögren secundario

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