title: Recurrence of primary hyperoxaluria after kidney transplantation.
abstract: Primary hyperoxaluria is a genetic disorder in glyoxylate metabolism that leads to systemic overproduction of oxalate. Functional deficiency of alanine-glyoxylate aminotransferase in this disease leads to recurrent nephrolithiasis, nephrocalcinosis, systemic oxalosis, and kidney failure. We present a young woman with end-stage renal disease who received a kidney allograft and experienced early graft failure presumed to be an acute rejection. There was no improvement in kidney function, and she was required hemodialysis. Ultimately, biopsy revealed birefringent calcium oxalate crystals, which raised suspicion of primary hyperoxaluria. Further evaluations including genetic study and metabolic assay confirmed the diagnosis of primary hyperoxaluria type 1. This suggests a screening method for ruling out primary hyperoxaluria in suspected cases, especially before planning for kidney transplantation in patients with end-stage renal disease who have nephrocalcinosis, calcium oxalate calculi, or a family history of primary hyperoxaluria.
authors: Division of Nephrology, Department of Internal Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran. Malakoutian@ams.ac.ir
authors: Tahereh
authors: T
authors: Malakoutian
authors: Mojgan
authors: M
authors: Asgari
authors: Massoud
authors: M
authors: Houshmand
authors: Ronak
authors: R
authors: Mohammadi
authors: Omid
authors: O
authors: Aryani
authors: Esmaeel
authors: E
authors: Mohammadi Pargoo
authors: Ahad J
authors: AJ
authors: Ghods
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000175:diagnosis / Q000209:etiology* / Q000652:urine; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000473:pathology; D012008:Recurrence; D055815:Young Adult