Related Experiment Videos
[A pediatric case of ammonium acid urate lithiasis with ulcerative colitis]
Yasuyo Yamamoto1, Yasushi Kurokawa, Natsuo Oka
1Department of Urology, University of Tokushima School of Medicine, Tokushima, Japan.
Insights
A pediatric patient with ulcerative colitis developed ammonium acid urate kidney stones due to chronic diarrhea after surgery. This highlights a rare complication of inflammatory bowel disease in children.
Area of Science:
- Pediatric Urology
- Nephrology
- Gastroenterology
Background:
- Ulcerative colitis (UC) management can lead to complications.
- Severe diarrhea in pediatric patients requires intensive management.
- Inflammatory bowel disease (IBD) can have extraintestinal manifestations.
Observation:
- A 13-year-old boy with UC, status post total colectomy, presented with severe diarrhea.
- Incidental abdominal CT revealed bilateral renal calculi.
- One calculus migrated and caused urethral obstruction.
Findings:
- Urethral stone analysis revealed pure ammonium acid urate composition.
- Ammonium acid urate lithiasis is uncommon, particularly in Japan.
- Chronic diarrhea associated with IBD is a risk factor.
Implications:
- Recognize ammonium acid urate stones as a potential complication in children with IBD and chronic diarrhea.
- Consider metabolic evaluation in pediatric IBD patients with urolithiasis.
- This case underscores the importance of monitoring for urinary tract complications in IBD patients.
Abstract:
A 13-year-old boy with ulcerative colitis was admitted to our hospital for the purpose of controlling diarrhea. He had received total colectomy and had been managed by intravenous hyper alimentation because of severe diarrhea (10 times/day). Oral intake had been prohibited except for fluid. Abdominal CT scan incidentally revealed two small calculi in the left kidney, which were left untreated. Two months later, one of them descended and was impacted into the urethra. Transurethral cystolitholapaxy showed the stone composition to be pure ammonium acid urate. Although ammonium acid urate lithiasis is rare in Japan, it should be reminded as a complication of chronic diarrhea secondary to inflammatory bowel disease in children.