Sulfadiazine-related obstructive urinary tract lithiasis: an unusual cause of acute renal failure after kidney transplantation.
We report on the first case of acute renal failure related to obstructive urinary tract lithiasis involving sulfadiazine crystals in a kidney transplant recipient. This patient had disseminated toxoplasmosis which was treated by sulfadiazine (4 g/day) and pyrimethamine (50 mg/day). In the fourth week of anti-toxoplasmosis therapy, he presented with obstructive acute renal failure: the plasma creatinine level increased from 220 micromol/l to 547 micromol/l. Apercutaneous pyelography was conducted showing the presence of a lithiasis located at the junction between the graft ureter and the bladder. Six days later, he underwent surgery to retrieve an orange-colored, friable stone. Its spectrophotometric analysis confirmed that the stone consisted of N-acetyl sulfadiazine crystals.
Guitard
J
J
Department of Nephrology, Dialysis and Transplantation, CHU Rangueil, Toulouse, France.
Kamar
N
N
Mouzin
M
M
Borde
J S
JS
Tran-Van
T
T
Durand
D
D
Rostaing
L
L
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000503:physiopathology; D000328:Adult; D004322:Drainage / Q000379:methods; D005500:Follow-Up Studies; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008096:Lithotripsy / Q000379:methods; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D013411:Sulfadiazine / Q000009:adverse effects* / Q000627:therapeutic use; D014123:Toxoplasmosis / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D001744:Urinary Bladder Calculi / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D014545:Urinary Calculi / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy*
D013411:Sulfadiazine