A child with atypical celiac disease and recurrent urolithiasis

Area of Science:

• Nephrology
• Pediatric Nephrology
• Gastroenterology

Background:

• Recurrent kidney calculi in children can lead to severe complications like acute kidney failure and hydronephrosis.
• Calcium phosphate calculi are a significant concern in pediatric nephrology.
• Identifying underlying causes is crucial for effective management.

Observation:

• A young boy experienced severe, recurrent calcium phosphate kidney calculi requiring multiple surgeries.
• Serum immunoglobulin E testing identified food allergies as a potential contributing factor.
• The patient had a history of constipation.

Findings:

• Implementing a gluten-free diet led to the complete cessation of kidney calculus formation.
• The patient has remained free of kidney calculi and related surgeries since adopting the diet.
• Notably, hyperoxaluria was not detected via 24-hour urine analysis, differing from other reported cases.

Implications:

• This case suggests a potential association between undiagnosed food allergies, gluten intolerance, and calcium phosphate kidney stone formation in children.
• Dietary interventions, specifically a gluten-free diet, may be a viable treatment for specific pediatric kidney stone cases.
• Further research is warranted to explore the mechanisms linking gluten sensitivity, food allergies, and nephrolithiasis in the absence of hyperoxaluria.