Progressive peripheral neuropathy in patient with primary hyperoxaluria.

Moorhead, P J; Cooper, Debora; Timperley, W R

doi:10.1136/bmj.2.5966.312

Cited by 34 publications

(14 citation statements)

References 7 publications

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“…Deposition within nerves and muscles can cause painful myopathies and progressive polyradiculoneuropathy. Biopsies of peripheral nerves reveal crystal deposition within axons and epineural blood vessels with associated axon loss and demyelination 61–64 . Oxalosis may also involve teeth 65–67 and blood vessels of the heart and liver 68, 69 .…”

Section: Signs and Symptomsmentioning

confidence: 99%

Update on Oxalate Crystal Disease

et al. 2013

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Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid. This condition typically occurs in patients with underlying primary or secondary hyperoxaluria. Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate, whereas secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate. In both conditions oxalate crystals can deposit in the kidney leading to renal failure. Since oxalate is primarily renally eliminated, it accumulates throughout the body in renal failure, a state termed oxalosis. Affected organs can include bones, joints, heart, eyes and skin. Since patients can present with renal failure and oxalosis before the underlying diagnosis of hyperoxaluria has been made, it is important to consider hyperoxaluria in patients who present with unexplained soft tissue crystal deposition. The best treatment of oxalosis is prevention. If patients present with advanced disease, treatment of oxalate arthritis consists of symptom management and control of the underlying disease process.

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Section: Signs and Symptomsmentioning

confidence: 99%

Update on Oxalate Crystal Disease

et al. 2013

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“…While the crystals are frequently widely distributed, their deposition in the central nervous system appears exceptionally rare. Recently, Moorhead et al (1975) found calcium oxalate crystals in peripheral nerves which were considered as a cause of progressive peripheral neuropathy in that patient.…”

Section: Discussionmentioning

confidence: 97%

Crystals in brain and meninges in primary hyperoxaluria and oxalosis.

Haqqani¹

1977

J Clin Pathol

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“…Inflammation is present but is not a prominent feature. The hexagonal and starburst crystals of oxalate polyneuropathy are distinctive and, in a patient with primary hyperoxaluria, they are diagnostic of calcium oxalate monohydrate deposition within nerve . Oxalate crystals are often perinodal and within the Schwann cell cytoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few case reports have described the nerve pathology associated with PH1. Demyelination (particularly at the internodes) and axonal degeneration have been reported, and some reports described intraneural crystal deposition . The characterization and location of these crystals within nerve has not been well described, and their pathological significance has remained unclear .…”

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confidence: 99%

Progressive polyradiculoneuropathy due to intraneural oxalate deposition in type 1 primary hyperoxaluria

et al. 2015

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Introduction A 24 year old man with primary hyperoxaluria type 1 (PH1) presented with a rapidly progressive axonal and demyelinating sensorimotor polyradiculoneuropathy shortly after the onset of end stage renal disease. His plasma oxalate level was markedly elevated at 107 µmol/L (normal: <1.8 µmol/L). Methods A sural nerve biopsy was performed. Teased fiber, paraffin and epoxy sections, and morphometric procedures were performed on this sample and on an archived sample from a 22 year old man as an age- and gender-matched control. Embedded teased fiber electron microscopy was also performed. Results The biopsy revealed secondary demyelination and axonal degeneration. Under polarizing light, multiple bright hexagonal, rectangular, and starburst inclusions typical of calcium oxalate monohydrate crystals were seen1,2,3. Discussion Proposed mechanisms of nerve damage include disruption of axonal transport due to crystal deposition, toxic effect of oxalate, or nerve ischemia related to vessel occlusion from oxalate crystal deposition.

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Progressive peripheral neuropathy in patient with primary hyperoxaluria.

Cited by 34 publications

References 7 publications

Update on Oxalate Crystal Disease

Update on Oxalate Crystal Disease

Crystals in brain and meninges in primary hyperoxaluria and oxalosis.

Progressive polyradiculoneuropathy due to intraneural oxalate deposition in type 1 primary hyperoxaluria

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