Rapidly developing renal milk of calcium in a patient with myelomonocytic leukaemia

Morjaria, Anika; Balasubramaniam, Gowrie; Perera, Saman; Almond, Michael

doi:10.1177/2054270414533324

Cited by 2 publications

(3 citation statements)

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“…MOC is reported mainly with calyceal diverticulum or renal cysts and less frequently in the dilated calyces of hydronephrotic kidney [12]. Urinary obstruction and stasis may lead to super-saturation of calcium salts which form calcium microliths but it is not clear in literature, why it does not form stones [4,6]. The current series is the largest reported series including seven cases of renal MOC in hydronephrotic kidneys.…”

Section: Discussionmentioning

confidence: 92%

“…This may contain calcium carbonate, phosphate, oxalate, or a mixture of these components [1,2]. Milk of calcium stones are well reported in association with calyceal diverticulum and renal cysts and can be also found in extra-urinary sites as the gastrointestinal tract (gall bladder) or bronchogenic cysts [3,4]. Only few cases of renal milk of calcium in hydronephrotic kidneys have been reported [5].…”

Section: Introductionmentioning

confidence: 99%

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Milk of calcium stones: radiological signs and management outcome

El-Shazly

2015

Urolithiasis

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Milk of calcium (MOC) is a rare type of stone that was first described in 1940 by Ludin and Howald who reported MOC in renal cysts. Milk of calcium is a viscous colloidal suspension of calcium salts. Stasis, obstruction and infection are important predisposing factors. Due to a layering effect, characteristic radiological signs especially in CT can help in diagnosis to avoid unsuccessful shock wave lithotripsy. This is the largest reported case series, in which radiological signs by CT scan to predict renal MOC stones, clinical picture and management outcome are described in detail. Cases with suspected renal milk of calcium stones were studied over 7 years (2008-2015). All cases were diagnosed preoperatively by non-contrast CT. Urine cultures were performed in all patients preoperatively. Intra-operative and postoperative findings were reported. Stones retrieved were sent for chemical analysis using an infrared method. Seven cases of milk of calcium renal stones were included in this study. These stones were faint radio-opaque in two cases and radiolucent in five cases. All cases were diagnosed preoperatively with non-contrast CT. Their Hounsfield units (HU) ranged from 114 to 612. All stones were located in a dependent position (gravitational effect) in the posterior aspect of dilated calyces. Five cases exhibited the typical fluid level and two cases demonstrated semilunar (half moon) pattern in the anterior surface of the stones. All cases underwent PCNL with suction and retrieval of soft stones without the need for disintegration. When stones demonstrate a low Hounsfield unit, are arranged in dependent positions within dilated calyces and exhibit fluid level or semilunar pattern on non-contrast CT, milk of calcium stones should be considered. PCNL is an effective modality for management of renal milk of calcium stones.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Milk of calcium stones: radiological signs and management outcome

El-Shazly

2015

Urolithiasis

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“…Milk of calcium is a viscous colloidal suspension of calcium carbonate, phosphate or oxalate, or a mixture of these compounds [1] . Formation of milk of calcium in the urinary tract requires poor urine flow and relative patient inactivity.…”

Section: Introductionmentioning

confidence: 99%