ABSTRACT
OBJECTIVE: Topiramate is a sulfamate-substituted monosaccharide anticonvulsant used as adjunctive therapy for intractable refractory seizures. It is report a case of topiramate-induced urolithiasis. CASE REPORT: A 35-year-old man presented with acute, right-sided, colicky flank pain. He denied hematuria or dysuria. He was in use of phenytoin, risperidone, phenobarbital, and topiramate. The total daily dose of topiramate was 375 mg. A CT scan showed a 7 x 1 mm curvilinear density at the right ureterovesical junction with proximal hydrouretronephrosis. He was managed with rigid ureteroscopic stone extraction and the calculus metabolic analysis revealed the stone was composed of carbonate apatite (70 percent), calcium oxalate dihydrate (20 percent), and calcium oxalate monohydrate (10 percent). COMMENTS: The present case typifies many features of topiramate-induced urolithiasis. Those who care for patients with urinary stone disease should be aware of this association.
Subject(s)
Adult , Humans , Male , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Fructose/adverse effects , Fructose/analogs & derivatives , Fructose/therapeutic use , Urinary Calculi/chemically induced , Acute Disease , Abdominal Pain/etiology , Seizures/drug therapy , Urinary Calculi/surgeryABSTRACT
El desarrollo tecnológico esta revolucionando el tratamiento de la litiasis urinaria mediante la introducción de métodos no quirúrgicos e incluso no invasores que garantizan elevadas tasas de curación con minimas complicaciones y enorme reducción de la incapacidad posterior al tratamiento. Una vez eliminados los cálculos, el tratamiento médico puede ayudar a prevenir las recidivas con base en un adecuado estudio de los factores de riesgo y su modificación mediante diversas modalidades terapéuticas que permitan corregir las alteraciones fisicoquímicas responsables de la formación de cálculos urinarios.