title: Ureteral stones due to systemic mastocytosis: diagnostic and therapeutic characteristics.
abstract: Urolithiasis is expected to cause a considerable complication in patients with systemic mastocytosis. The aim of the present report is to demonstrate that due to pathological activation and irritability of mast cells, special features in the diagnostic investigation and therapy of urolithiasis have to be considered in patients with systemic mastocytosis. The clinical presentation, diagnostic investigation and therapeutic procedure of urolithiasis in a patient with systemic mastocytosis are described. Urolithiasis may be a significant complication of systemic mastocytosis. Non-contrast CT is the main tool for diagnosing urolithiasis after a detailed history and clinical exam. Patients with systemic mastocytosis should receive a premedication composed of a glucocorticoid and H(1)- and H(2)-histamine receptor antagonists. An increased vulnerability of mucosal tissues is expected in patients with systemic mastocytosis that may limit the options of operative and postoperative therapy. Opioids should be used cautiously for analgesia in patients with systemic mastocytosis.
authors.affiliation: Institute of Human Genetics, University Hospital of Bonn, Bonn, Germany. molderings@uni-bonn.de
authors.forename: Gerhard J
authors.initials: GJ
authors.lastname: Molderings
authors.forename: Gerold
authors.initials: G
authors.lastname: Solleder
authors.forename: Ulrich W
authors.initials: UW
authors.lastname: Kolck
authors.forename: Jürgen
authors.initials: J
authors.lastname: Homann
authors.forename: Detlev
authors.initials: D
authors.lastname: Schröder
authors.forename: Ivar
authors.initials: I
authors.lastname: von Kügelgen
authors.forename: Roland
authors.initials: R
authors.lastname: Vorreuther
mesh_terms: D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D015907:Hysteroscopy; D008297:Male; D008407:Mast Cells / Q000473:pathology; D034721:Mastocytosis, Systemic / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010808:Physical Examination; D011239:Prednisolone / Q000627:therapeutic use; D011899:Ranitidine / Q000627:therapeutic use; D016593:Terfenadine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis* / Q000473:pathology; D052878:Urolithiasis / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D039563:Histamine H1 Antagonists, Non-Sedating; D006635:Histamine H2 Antagonists; D016593:Terfenadine; D011899:Ranitidine; D011239:Prednisolone; C093230:fexofenadine