Reversal of pancytopenia following kidney transplantation in a patient of primary hyperoxaluria with bone marrow involvement.
Combined liver and kidney transplantation is the ideal treatment for patients with end-stage renal failure secondary to primary hyperoxaluria and systemic oxalosis, with a functioning liver providing replacement of the deficient enzyme and a functioning kidney providing the route of excretion for the oxalate crystals. Pancytopenia from bone marrow infiltration of oxalate crystals is a rare complication of primary hyperoxaluria, and its reversal following transplant has not been described. We report the first case of pancytopenia from marrow infiltration by oxalate crystals reversing following a successful kidney transplant alone. Although kidney alone transplants do not provide the best chance of survival or quality of life as compared to a combined kidney and liver transplant, a well functioning kidney transplant is able to take care of the systemic oxalate load and ameliorate, at least for a period of time, the systemic complications of oxalosis.
Sud
Kamal
K
Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Swaminathan
Sundararaman
S
Varma
Neelam
N
Kohli
Harbir Singh
HS
Jha
Vivekanand
V
Gupta
Krishan Lal
KL
Sakhuja
Vinay
V
D000328:Adult; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology*; D003460:Crystallization; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D010070:Oxalates / Q000378:metabolism; D010198:Pancytopenia / Q000209:etiology*; D012008:Recurrence
D010070:Oxalates