title: Application of nuclear magnetic resonance spectroscopy for identification of ciprofloxacin crystalluria.
abstract: This is a report describing a previously healthy young patient, who experienced crystalluria and non-cholestatic acute liver injury after a single intravenous dose of 400mg. The nuclear magnetic resonance spectra confirmed that the urinary sediment in our patient was formed by pure ciprofloxacin. The nuclear magnetic resonance spectra ((1)H NMR) of the urine sediment are a good test to confirm the composition of the crystals observed by electron microscopy and infrared spectrum. The findings indicate the importance of adequate hydration, urinalysis, measurement of pH and liver enzyme levels, prior to treatment with ciprofloxacin. Our findings also indicate that ciprofloxacin should not be administered to patients with renal tubular acidosis, due to their high urinary pH.
authors.affiliation: Department of Clinical Chemistry, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Electronic address: dr.morell.uab@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Morell-Garcia
authors.affiliation: Department of Clinical Chemistry, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Barceló
authors.affiliation: Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISPa), Universitat de les Illes Balears, Palma de Mallorca, Spain.
authors.forename: Adrian
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: Emergency Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Liñeiro
authors.affiliation: Emergency Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Robles
authors.affiliation: Emergency Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Vidal-Puigserver
authors.affiliation: Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISPa), Universitat de les Illes Balears, Palma de Mallorca, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Costa-Bauzá
authors.affiliation: Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISPa), Universitat de les Illes Balears, Palma de Mallorca, Spain.
authors.forename: Felix
authors.initials: F
authors.lastname: Grases
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000652:urine; D002939:Ciprofloxacin / Q000009:adverse effects* / Q000652:urine; D003460:Crystallization; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin
keywords: Ciprofloxacin; NMR spectroscopy; Urinalysis; Urolithiasis