ABSTRACT
An 11-year-old boy who presented in acute renal failure with significant increases of uric acid and phosphorus in his serum was discovered to have acute lymphoblastic leukemia. Five years later, he had a second and similar episode of acute renal failure, which was responsive to hemodialysis. After three months of daily therapy with allopurinol, a third and final episode of renal failure was unresponsive to peritoneal dialysis. Autopsy revealed an obstructive uropathy; focal nephrocalcinosis; and multiple, small, tan calculi in the calyces of both kidneys. Systemic cryptococcosis was also discovered. The stones, characterized by paper chromatography, electrophoresis, x-ray diffraction, and infrared spectroscopy, were 82% xanthine, 15% oxypurinol, and 3% hypoxanthine. We suggest that attention to the effects of accelerated tumor-cell lysis may protect renal function in patients with a large and drug-sensitive tumor cell load. Similarly, early detection of the fungal complications of leukemic therapy is an essential component of the treatment program.
Subject(s)
Acute Kidney Injury/etiology , Allopurinol/adverse effects , Kidney Calculi/etiology , Leukemia, Lymphoid/complications , Xanthines/analysis , Child , Humans , Kidney Calculi/analysis , Male , Phosphorus/blood , Uric Acid/blood , XanthineSubject(s)
Arginine/urine , Hair/abnormalities , Metabolism, Inborn Errors , Succinates/urine , Amino Acids/analysis , Ammonia/blood , Ataxia/etiology , Blood Urea Nitrogen , Child, Preschool , Chromatography, Paper , Cystine/physiology , Electroencephalography , Epilepsy, Tonic-Clonic/etiology , Female , Hair/analysis , Humans , Intellectual Disability/etiology , Stress, Mechanical , SyndromeSubject(s)
Cystic Fibrosis/metabolism , Saliva/analysis , Sodium/analysis , Female , Humans , Magnetic Resonance Spectroscopy , MaleABSTRACT
Nuclear magnetic resonance (NMR) was used to determine Na(+) complexing in muscle and liver (at 23 degrees C) from bullfrogs (Rana catesbeiana) and to study the influence of temperature on Na(+) complexing in muscle from leopard frogs (Rana pipiens). The Na(+) complexed in muscle and liver was found to be 36.6 +/- 4.6% and 66.1 +/- 3.5% respectively. A temperature decrease from +34 degrees C to -2 degrees C results in a 20% decrease in the mobility of the free Na(+) in the fresh muscle. This 20% decrease in mobility results in about 50% of the free Na(+) at 34 degrees C being complexed at the lower temperature.
