[Therapy-induced cerebro-renal oxalosis?]

Report on three cases of a cerebro-renal oxalosis. The clinical picture was characterized by subacutely appearing coma and cerebral paroxysms. Death occurred due to break-down of cerebral regulation. In all three cases the post-mortem examination showed massive subendothelial depositions of double refractive crystals in the cerebral vessels, in particular in the stem ganglia regions and in the renal tubuli. The crystals showed several features typical for calcium oxalate. The clinical picture appears as an infrequent complication within intensive medicine, in connection with parenteral administration of xylit. Differential diagnosis, pathogenesis and possible cofactors are discussed.