Renal oxalate stones in children with Zellweger spectrum disorders

Hamdan Hammad Alhazmi1

  • 1Department of Surgery, Division of Urology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Insights

Zellweger spectrum disorders (ZSDs) can cause kidney problems like oxalate stones. Early screening for hyperoxaluria in ZSD patients is crucial to prevent renal damage.

Area of Science:

  • Biochemistry
  • Genetics
  • Pediatrics

Background:

  • Peroxisomal biogenesis disorders (PBDs) arise from PEX gene defects, with Zellweger spectrum disorders (ZSDs) being the most common subgroup.
  • ZSDs manifest in neonatal, adolescent, or adult phenotypes, exhibiting variable clinical severity and metabolic abnormalities due to impaired peroxisomal function.

Observation:

  • A case study identified oxalate renal stones in a patient diagnosed with ZSD.
  • The patient presented with hyperoxaluria and hyperglycolic aciduria, indicating a significant urinary oxalate load.

Findings:

  • Radiological evaluation confirmed renal involvement, including urolithiasis (kidney stones) and nephrocalcinosis (kidney calcification).
  • Assessment of urinary oxalate and glycolate excretion correlated with the observed clinical signs of hyperoxaluria.

Implications:

  • The findings highlight the importance of screening ZSD patients for urinary stones and hyperoxaluria using urinalysis and ultrasonography.
  • Early detection and intervention are recommended to mitigate renal damage and improve patient outcomes in ZSD.

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