title: Bilateral urinary calculi after treatment with a silicate-containing milk thickener.
abstract: Nephrocalcinosis and/or urinary calculi are rare in infants. Furosemide treatment during the neonatal period, vitamin D intoxication, hereditary diseases such as hyperoxaluria or distal tubular acidosis are among the most common aetiologies. We report the case of a 6-month-old boy with an extra-hepatic biliary duct atresia treated by the Kasai procedure and a gastro-oesophageal reflux treated with a silicate containing milk thickener (Gelopectose, 5.5% colloidal silicate) since the neonatal period. He did not present any other endogenous risk factor for urinary stone formation (normal urinary calcium/creatinine ratio; normal urinary magnesium excretion). The nephrolithiasis was discovered as the boy presented painful episodes of macroscopic haematuria. Ultrasound examination revealed bilateral nephrocalcinosis and multiple bilateral calculi without infection or urinary obstruction. Infrared spectroscopy revealed silicate as the major component suggesting silicate absorption to be responsible for the described symptoms. After replacement of the silicate-containing agent by a silicate-free milk thickener, the lesions were completely reversible as confirmed by repeated renal ultrasound examinations over a 2-month period.
  
  
  CONCLUSIONS
  Silicate-containing milk thickeners can be responsible for urinary calculi and/or nephrocalcinosis.
authors.affiliation: Department of Paediatrics, Hôpital Edouard Herriot, 3, place d'Arsonval, 69437 Lyon cedex 03, France.
authors.forename: Tim
authors.initials: T
authors.lastname: Ulinski
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Sabot
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bourlon
authors.forename: Pierre
authors.initials: P
authors.lastname: Cochat
mesh_terms: D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006417:Hematuria / Q000139:chemically induced; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008297:Male; D010368:Pectins / Q000009:adverse effects* / Q000627:therapeutic use; D017655:Silicon Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography; D014545:Urinary Calculi / Q000139:chemically induced*
chemical_list: D017655:Silicon Compounds; C044889:gelopectose; D010368:Pectins