30.01.2024 | Scientific Letter
Silicate Calculi: A Rare Form of Pediatric Nephrolithiasis
verfasst von:
Madhileti Sravani, Bobbity Deepthi, Sudarsan Krishnasamy, Kumaravel Sambandan, Sriram Krishnamurthy
Erschienen in:
Indian Journal of Pediatrics
|
Ausgabe 8/2024
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Excerpt
To the Editor: A 13-y-old boy presented with bilateral flank pain for 8 mo; and vomiting with oliguria for 2 d. There was no history of antacid intake, jaundice, fever, hematuria or dysuria; and no family-history of nephrolithiasis. He was normotensive. The weight was 29.7 kg (-1.2 z), height 143 cm (0.37 z). There was no renal-angle tenderness. Urinalysis showed no cells, proteinuria or crystals; urine pH was 7.4. The serum-creatinine was high (1.08 mg/dL; eGFR 55 ml/1.73 m2/min). Serum sodium 133 mEq/L, potassium 4.6 mEq/L, calcium 9.13 mg/dL, magnesium 1.8 mg/dL, phosphate 4.36 mg/dL and uric acid 3.2 mg/dL were normal. There was no hypercalciuria or hyperuricosuria. Renal-ultrasonogram revealed right distal-ureter calculus measuring 0.7x1.3x1.2 cm with severe hydroureteronephrosis (15 mm pelvic diameter); left kidney showed 14 mm calculus in left-renal pelvis without hydronephrosis. The obstructive right-distal ureteral calculi was handled by robotic ureterolithotomy followed by left robotic pyelolithotomy as extracorporeal-shock-wave-lithotripsy (ESWL) failed and percutaneous nephrolithotomy (PCNL) pediatric equipment was unavailable. The stones retrieved surgically showed 100% silicon-dioxide calculi by Fourier-transform-infrared-spectroscopy (FTIR). He was advised a salt-restricted diet with adequate hydration. No new stone formation was noted at 6-mo follow-up, and serum-creatinine normalized (0.56 mg/dL). …