title: Obstructive nephropathy secondary to sulfasalazine calculi.
abstract: The incidence of drug-induced stone disease is 0.44%. A 57-year-old woman with ulcerative colitis presented with obstructive nephropathy and pyelonephritis. She underwent cystoscopy, bilateral retrograde pyelography, and bilateral ureteral stent placement. A 6-cm bladder calculus and two 3-mm right distal ureteral calculi were discovered. Later, cystolithotomy was performed. The stone analysis demonstrated sulfapyridine, a sulfasalazine metabolite. Patients with inflammatory bowel disease can develop urolithiasis owing to acidic urine and low-volume urine production. Patients receiving aminosalicylates are at an increased risk of urolithiasis and may benefit from oral hydration and urinary alkalization.
authors.affiliation: Roger Williams Medical Center, Brown University School of Medicine, Providence, Rhode Island 02904, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Russinko
authors.forename: Saraub
authors.initials: S
authors.lastname: Agarwal
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Choi
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Kelty
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000493:pharmacokinetics; D003093:Colitis, Ulcerative / Q000150:complications* / Q000652:urine; D013293:Enterococcus faecalis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged; D011704:Pyelonephritis / Q000209:etiology / Q000382:microbiology; D013427:Sulfapyridine / Q000032:analysis*; D012460:Sulfasalazine / Q000009:adverse effects* / Q000493:pharmacokinetics; D014514:Ureteral Calculi / Q000139:chemically induced* / Q000737:chemistry / Q000209:etiology; D001744:Urinary Bladder Calculi / Q000139:chemically induced* / Q000737:chemistry / Q000209:etiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D013427:Sulfapyridine