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Renal failure due to 2,8-dihydroxyadenine urolithiasis

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Abstract

A four-year-old girl presented in renal failure due to dihydroxyadenine urolithiasis. Prior to this she had been fed a high purine macrobiotic diet, rich in pulses and grain. She was comatose, anuric, requiring peritoneal dialysis, and bilateral radiolucent renal calculi were revealed by ultrasonography and retrograde pyelography. 2,8-dihydroxyadenine stones were found at pyelolithotomy, renal biopsy revealed interstitial birefringent crystals, and a complete lack of adenine phosphoribosyl transferase (APRT) was found subsequently in erythrocyte lysates. APRT levels were initially falsely raised due to a blood transfusion on admission. The mother was shown to have heterozygote levels. The child was treated successfully with allopurinol, and a reduction in dietary purine but with only partial return of renal function.

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Greenwood, M.C., Dillon, M.J., Simmonds, H.A. et al. Renal failure due to 2,8-dihydroxyadenine urolithiasis. Eur J Pediatr 138, 346–349 (1982). https://doi.org/10.1007/BF00442515

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