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Recurrence of primary hyperoxaluria after kidney transplantation.
[primary hyperoxaluria type 1]
Primary
hyperoxaluria
is
a
genetic
disorder
in
glyoxylate
metabolism
that
leads
to
systemic
overproduction
of
oxalate
.
Functional
deficiency
of
alanine-glyoxylate
aminotransferase
in
this
disease
leads
to
recurrent
nephrolithiasis
,
nephrocalcinosis
,
systemic
oxalosis
,
and
kidney
failure
.
We
present
a
young
woman
with
end-
stage
renal
disease
who
received
a
kidney
allograft
and
experienced
early
graft
failure
presumed
to
be
an
acute
rejection
.
There
was
no
improvement
in
kidney
function
,
and
she
was
required
hemodialysis
.
Ultimately
,
biopsy
revealed
birefringent
calcium
oxalate
crystals
,
which
raised
suspicion
of
primary
hyperoxaluria
.
Further
evaluations
including
genetic
study
and
metabolic
assay
confirmed
the
diagnosis
of
primary
hyperoxaluria
type
1
.
This
suggests
a
screening
method
for
ruling
out
primary
hyperoxaluria
in
suspected
cases
,
especially
before
planning
for
kidney
transplantation
in
patients
with
end-
stage
renal
disease
who
have
nephrocalcinosis
,
calcium
oxalate
calculi
,
or
a
family
history
of
primary
hyperoxaluria
.
Diseases
Validation
Diseases presenting
"recurrent nephrolithiasis"
symptom
cystinuria
primary hyperoxaluria type 1
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