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[Therapy-induced cerebro-renal oxalosis?]
M Bergmann1, G Silling-Engelhardt, R Schnabel
1Institut für Neuropathologie, Universität Münster.
Abstract:
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.
Insights
Subacute coma and cerebral issues in three patients were linked to cerebro-renal oxalosis. Post-mortem analysis revealed calcium oxalate crystals in the brain and kidneys, often associated with xylitol administration.
Area of Science:
- Nephrology
- Neurology
- Toxicology
Background:
- Cerebro-renal oxalosis is a rare condition.
- Parenteral administration of xylitol can be a potential trigger.
Observation:
- Three cases presented with subacute coma and cerebral paroxysms.
- Clinical deterioration led to death due to impaired cerebral regulation.
Findings:
- Autopsy revealed massive subendothelial calcium oxalate crystal deposition in cerebral vessels and renal tubules.
- Crystal analysis confirmed features consistent with calcium oxalate.
Implications:
- This condition is an infrequent complication in intensive care medicine.
- Understanding pathogenesis and cofactors is crucial for diagnosis and management.