Renal lithiasis in a patient with primary hypothyroidism

Case report.

Abstract

Introduction: Idiopathic hypercalciuria 35%, persistently acid urine 13.3%, hyperuricosuria 9.3%, hypocitraturia 5%, hypomagnesuria 4%, primary hyperparathyroidism 2%, hyperoxaluria 1.4% and cystinuria 1% are causes of most incidences of kidney stones. A sporadic case of association between kidney stones and primary hypothyroidism not previously reported is presented.

Clinical case: This is a 16-year-old boy who debuted with kidney stones (2 stones) with recurrent episodes in the sixth month (1 single stone in the renal pelvis) that required lithotripsy and new episodes of subsequent microlithiasis. Additionally, the patient presented non-glomerular persistent isolated hematuria, alopecia, and intolerance to cold. Dietary alterations with low water intake, high sodium, and protein intake.

Diagnostic workshop: The patient was classified as a carrier of metabolically active stones. The metabolic study established the presence of hypercalciuria (calciuria > 140 and < 300 mg/day in men) dependent on diet (absorptive type II), with a calciuria/creatinuria ratio <0.11mg/mg. Primary hypothyroidism was also diagnosed.

Evolution: With hydration and vegan dietary treatment, hydrochlorothiazide, citrate replacement, and levothyroxine, it has been possible to reduce calciuria and eliminate episodes of kidney stones to date.