ABSTRACT
Kelley-Seegmiller syndrome (KSS) is a disorder that occurs when there is a partial deficiency of the enzyme hypoxanthine guanine phosphoribosyl transferase. It is involved in the metabolism of purines, clinically manifesting as hyperuricemia, hyperuricosuria, gout arthritis, and urolithiasis. The aim of this article is to present the case of a 33-year-old male with KSS, with left ureteral colic, and a 5-mm, 323-HU ureteral calculi, successfully managed with conservative management. It is critical to recognize that most urologists are not familiar with this inborn metabolic error and 75% of these patients will be affected by urolithiasis, thus making it a very critical and significant disease in our practice.
Subject(s)
Conservative Treatment , Gout/therapy , Hypoxanthine Phosphoribosyltransferase/deficiency , Kidney/metabolism , Renal Colic/therapy , Ureteral Calculi/therapy , Uric Acid/metabolism , Urologists , Adult , Gout/diagnosis , Gout/genetics , Gout/metabolism , Humans , Hypoxanthine Phosphoribosyltransferase/genetics , Hypoxanthine Phosphoribosyltransferase/metabolism , Kidney/diagnostic imaging , Male , Professional Role , Renal Colic/diagnosis , Renal Colic/genetics , Renal Colic/metabolism , Tomography, X-Ray Computed , Treatment Outcome , Ureteral Calculi/diagnosis , Ureteral Calculi/genetics , Ureteral Calculi/metabolismABSTRACT
PURPOSE: Neutrophil gelatinase-associated lipocalin (NGAL) levels in the serum and urine are predictive biomarkers of acute kidney injury with correlation to complication and survival in major surgery. Salivary levels of NGAL during acute renal colic may reflect the degree of renal injury as it appears in different compartments encompassing body response in time perspective. Our aim is to evaluate and examine the feasibility and correlation of salivary NGAL with serum and urine levels in acute renal colic event. MATERIALS AND METHODS: A prospective controlled study of all patients presenting to the emergency room with acute renal colic event diagnosed with single ureteral stone obstruction by noncontrast CT. Saliva, urine, and blood samples were collected in patients and a control group during the first morning of admission. RESULTS: The study groups consisted of 44 patients and 13 controls, mean age 47 ± 15 years, body mass index 29 ± 6, mean stone size 6 ± 4 mm, mean creatinine levels 1.3 ± 0.7 mg/dL, mean white blood count 10,900 ± 3100 counts per field, and C-reactive protein 29 ± 55. Serum (190 ± 120 ng/mL vs 81 ± 24; p < 0.001) and predominantly salivary (474 ± 185 vs 328 ± 134 ng/mL; p < 0.05) NGAL levels were significantly elevated in patients compared with controls. CONCLUSIONS: Salivary NGAL sampling is feasible during the acute phase of renal colic. High levels of salivary NGAL are observed in a single sampling during acute ureteral stone obstruction and may advance clinical decision-making.
Subject(s)
Kidney Calculi/metabolism , Lipocalin-2/analysis , Renal Colic/metabolism , Saliva/chemistry , Acute Kidney Injury/etiology , Acute-Phase Proteins/urine , Adult , Aged , Biomarkers/analysis , C-Reactive Protein/analysis , Case-Control Studies , Creatinine/blood , Feasibility Studies , Female , Humans , Lipocalins/urine , Lymphocyte Count , Male , Middle Aged , Prospective Studies , Proto-Oncogene Proteins/urine , Ureteral Obstruction/metabolismABSTRACT
OBJECTIVE: To investigated oxidative stress changes in renal colic patients, and to determine its role in differential diagnosis of renal colic. METHODS: The cross-sectional study was conducted at Ankara Atatürk Training and Research Hospital, Turkey, from June 2012 to December 2012 and comprised patients with complaints suggesting of renal colic and diagnosed with urinary stone. Healthy individuals were enrolled to form the control group. The patients and the control group were evaluated in terms of oxidative stress parameters. SPSS 17 was used for statistical analysis. RESULTS: Of the 83 subjects, 50(60%) were patients with renal colic, while 33(40%) were healthy controls. Among the patients, 25(50%) were men and 25(50%) were women. Among the controls, there were 17(51.5%) men and 16(48.5%) women. No statistically significant difference was found between the two groups in terms of age and gender (p>0.05). Likewise, no statistically significant difference was found between the oxidative stress indexes of the two groups (p>0.05). CONCLUSIONS: There was no significant increase in oxidative stress in patients with renal colic. The result may help in the differential diagnosis of patients with abdominal pain.
