title: Stroke in primary hyperoxaluria type I.
abstract: We report the case of a 27-year-old man with a history of previously undiagnosed renal disease that presented with multiple cerebrovascular infarctions. Workup for traditional causes of cerebrovascular infarction including cardiac telemetry, multiple echocardiograms, and hypercoagulative workup was negative. However, a transcranial Doppler detected circulating microemboli at the rate of 14 per hour. A serum oxalate level greater than the supersaturation point of calcium oxalate was detected, providing a potential source of the microemboli. Furthermore, serial imaging recorded rapid mineralization of the infarcted territories. In the absence of any proximal vessel irregularities, atherosclerosis, valvular abnormalities, arrhythmias, or systemic shunt as potential stroke etiology in this patient, we propose that circulating oxalate precipitate may be a potential mechanism for stroke in patients with primary oxalosis.
authors.affiliation: David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Neal M
authors.initials: NM
authors.lastname: Rao
authors.forename: Anil
authors.initials: A
authors.lastname: Yallapragada
authors.forename: Kellen D
authors.initials: KD
authors.lastname: Winden
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Saver
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000150:complications* / Q000473:pathology*; D020766:Intracranial Embolism / Q000209:etiology* / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D020521:Stroke / Q000209:etiology* / Q000473:pathology*
keywords: Stroke; genetics; hyperoxaluria; neuroimaging; primary oxalosis; transcranial Doppler
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