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Crystalluria during flucytosine therapy.

K M Williams, P M Chinwah, R Cobcroft

    The Medical Journal of Australia
    |December 1, 1979
    PubMed
    Summary
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    Flucytosine (5-fluorocytosine) treatment can cause urinary crystalluria. Reducing the flucytosine dosage decreased urinary gravel, a coprecipitate of the drug and uric acid.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Urology

    Background:

    • Flucytosine (5-fluorocytosine) is an antifungal medication.
    • Urinary crystalluria is the presence of crystals in the urine.
    • Drug-induced crystalluria can lead to kidney damage.

    Observation:

    • A patient undergoing flucytosine treatment developed urinary crystalluria.
    • Urinary gravel, a form of crystalluria, was observed.
    • The gravel was identified as a coprecipitate of flucytosine and uric acid.

    Findings:

    • A reduction in flucytosine dosage led to a significant decrease in urinary gravel excretion.
    • This indicates a direct relationship between flucytosine dosage and crystalluria.
    • The crystalluria was specifically linked to the combined precipitation of flucytosine and uric acid.

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    Implications:

    • This case highlights a potential adverse effect of flucytosine.
    • Dosage adjustment of flucytosine may be a strategy to manage or prevent flucytosine-induced crystalluria.
    • Monitoring for urinary crystals in patients on flucytosine is recommended, especially in those with risk factors for uric acid stone formation.