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Cystinuria: the South Indian experience.
[cystinuria]
Cystinuria
is
reportedly
a
rare
condition
affecting
the
stone
patients
in
India
.
This
paper
presents
the
occurrence
of
cystine-related
abnormality
in
the
population
of
stone
patients
reporting
to
the
hospitals
in
South
India
.
Two
thousand
and
eight
hundred
urine
samples
from
1
,
300
patients
attending
the
urinary
stone
clinic
during
the
period
2004
-
2008
were
assessed
for
cystinuria
by
performing
the
nitroprusside
test
on
the
early
morning
urine
and
random
samples
on
the
day
of
attendance
.
Urinary
deposits
were
also
studied
in
all
the
patients
.
Stones
retrieved
from
800
stone
patients
were
analysed
qualitatively
and
by
Fourier
Transform
infra
red
(
FTIR
)
spectroscopy
.
Cystinuria
was
identified
in
only
three
patients
.
None
of
these
patients
showed
cystine
crystals
.
Three
other
patients
out
of
the
1
,
300
showed
presence
of
cystine
crystals
in
the
urine
deposit
.
FTIR
spectroscopy
of
the
stones
retrieved
from
the
patients
showed
presence
of
cystine
in
19
out
of
the
800
stones
analysed
(
2
.
375
%
)
.
None
of
the
patients
with
cystine
in
the
stones
had
either
cystine
crystals
in
the
urine
or
positive
nitroprusside
test
for
cystine
.
All
the
patients
who
had
positive
cystine
,
cystine
crystals
or
cystine
in
stone
analysis
had
other
biochemical
abnormalities
.
They
were
medically
managed
with
appropriate
biochemical
corrective
chemotherapy
and
had
control
of
stone
disease
process
.
All
the
patients
were
advised
purine
restriction
in
the
diet
.
It
is
concluded
from
the
study
that
cystinuria
is
a
rare
entity
in
South
India
.
It
,
however
,
exists
in
a
small
percentage
of
stone
patients
.
Specific
treatment
with
D-
penicillamine
was
not
administered
to
the
patients
in
view
of
the
high
cost
,
nonavailability
and
possible
toxicity
.
The
patients
considered
above
did
not
have
intractable
stone
disease
which
was
not
amenable
to
usual
modalities
of
directed
medical
therapy
.
Diseases
Validation
Diseases presenting
"random samples on the day of attendance"
symptom
cystinuria
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