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Thiazide therapy for ACTH-induced hypercalciuria and nephrolithiasis.
Z Katzir1, Y Shvil, E H Landau
1Nephrology Service, Hadassah University Hospital, Jerusalem, Israel.
Acta Paediatrica (Oslo, Norway : 1992)
|March 1, 1992
Summary
Adrenocorticotropic hormone (ACTH) therapy can cause hypercalciuria and kidney stones in infants. Thiazide medication effectively treated and prevented these conditions, suggesting its use in similar cases.
Area of Science:
- Pediatric Nephrology
- Endocrinology
Background:
- Infantile spasms are a severe epilepsy syndrome in infants.
- Adrenocorticotropic hormone (ACTH) therapy is a common treatment for infantile spasms.
- ACTH therapy is associated with potential side effects, including metabolic disturbances.
Observation:
- A one-year-old boy developed hypercalciuria and nephrolithiasis during ACTH treatment for infantile spasms.
- The patient underwent successful cystolithotripsy for kidney stones.
- Subsequent treatment with chlorothiazide led to the regression of hypercalciuria.
Findings:
- Hypercalciuria resolved within 42 months of chlorothiazide therapy.
- No recurrence of nephrolithiasis or nephrocalcinosis was observed.
- Thiazide therapy demonstrated efficacy in managing ACTH-induced hypercalciuria.
Implications:
- Thiazide diuretics may be a valuable prophylactic or therapeutic agent for preventing ACTH-induced hypercalciuria.
- This finding suggests a potential management strategy for pediatric patients undergoing ACTH therapy.
- Further research may explore the long-term benefits and optimal dosing of thiazides in this context.