International Journal of Clinical Case Reports, 2016, Vol.6, No.26, 1-4
1
ResearchReport Open Access
Primary hyperparathyroidism and urolithiasis: about a coralliform lithiasis case
M. J. Yousfi, M.A. Amani
Departments of Urology and Endocrinology, 1st November 1954 University Hospital of Oran, Algeria.
Corresponding author email
International Journal of Clinical Case Reports 2016, Vol.6, No.26 doi
Received: 4 Aug., 2016
Accepted: 11 Oct., 2016
Published: 12 Oct., 2016
This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article
:
Yousfi M. J., and Amani M.A., 2016, Primary hyperparathyroidism and urolithiasis: about a coralliform lithiasis case, International Journal of Clinical Case
Reports, 6(26): 1-4 (doi
Abstract
The primary hyperparathyroidism (PHPT) is not uncommon. The lithiasic events are the most common complication of
the PHPT. We report the case of a 53-year-old woman, with a heavy urological history with several extracorporeal lithotripsy
sessions for a right nephrolithiasis and a semirigid ureteroscopy for a right ureteral lithiasis, as well as a bilateral calc ium oxalate
coralliform lithiasis with right kidney consequences. This nephrolithiasis was due to a parathyroid macroadenoma. Through this
observation, we highlight that the coralliform lithiasis etiology is not always an infectious disease and the PHPT may be res ponsible
of this type of lithiasis as well as the nephrocalcinosis.
Keywords
Coralliform lithiasis; hyperparathyroidism; metabolic tests; surgical treatment.
1 Introduction
The primary hyperparathyroidism (PHPT) is, after the thyroid diseases, the most common endocrine disorder in
adults especially in women. Its incidence increased in the 90s with a current stabilization at 20.8 / 100.000
(Melton., 2002). The asymptomatic forms detected by a routine calcium dosage account for 80% of the cases
(Bilezikian JP., and Potts JT Jr., 2002). Some patients have a PHPT with renal consequences but they are
normocalcaemic (Dutta P. K., and al., 2015). The coralliform lithiasis represents the most common clinical
manifestation; about 3 to 5% of lithiasic patients have a PHPT. In Patients with persistent urinary hypercalcemia,
the PHPT is more common and reached to 10% of the cases (Clark and Duh., 1989). The coralliform lithiasis is a
rare urological manifestation of the PHPT and requires a multidisciplinary management.
2 Case reports
We report the case of a 53-year-old woman with a heavy urological history, a right ureteral lithias is (15mm)
treated in March 2013 through three sessions of extracorporeal lithotripsy. The patient was readmitted in April
2013 for a pelvic ureteral calculi treated with semirigid ureteroscopy fragmentation with laser. In February 2014,
an obstructive left lumbar ureteral calculi (12mm) was diagnosed and treated again with a semirigid ureteroscopy
with laser. The morphoconstitutional analys is of the lithiasis by infrared spectrophotometry showed an
oxalo-phosphate mixed nature. In September 2015, our patient consulted for a repeated renal colic associated with
fatigue and digestive disorders infections (pain and vomiting).A CT urography showed a recurr ent left coralliform
lithiasis (40mm, density =758 Hounsfield unit) in the pyelic region with middle and lower calices extension
(Figure 1). The patient was treated with the third generation cephalosporin and aminoglycosides after a urinary
antibiogram. After the negativation of urinary antibiogram, a percutaneous nephrolithotomy (NCCP) was
performed with a double surgical approach of the middle and the lower calices in two stages (Figure 2).The
morphoconstitutional results of the calculi showed a calcium oxalate structure (Figure 3).
The analysis by the infrared spectrophotometry showed:
-surface:Whewellite (C1)> Weddellite (C2)
-section and central mass: Whewellite (C1)> Weddellite (C2) and trace of carboapatite
-conclusion: oxalo structure and calcium-dependent lithiasis
