Reno-cerebral oxalosis induced by xylitol.
A 20-year-old man suffering from Crohn's disease developed coma and generalized seizures following ileocecal resection. During postoperative parenteral feeding he received xylitol in an unusually high concentration. CT examinations a few days before death showed intense hypodensity and swelling of brainstem and basal ganglia and increasing triventricular dilatation. Autopsy revealed, mainly in the brainstem and cerebellum, a destruction of intracerebral, intracerebellar and leptomeningeal vessel walls by birefringent crystals (probably calcium oxalate), an early inflammatory reaction and severe brain edema with final tonsillar herniation. The same crystalloid deposits were found in the kidneys.
D000328:Adult; D001927:Brain Diseases / Q000139:chemically induced*; D002129:Calcium Oxalate / Q000378:metabolism*; D002539:Cerebral Arterial Diseases / Q000139:chemically induced; D003424:Crohn Disease / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects; D007669:Kidney Calculi / Q000139:chemically induced; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D014057:Tomography, X-Ray Computed; D014993:Xylitol / Q000009:adverse effects* / Q000627:therapeutic use
D002129:Calcium Oxalate; D014993:Xylitol