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WCE 2007 - Phenytoin Metabolite Renal Calculus

Written by Aldrin Joseph R. Gamboa, M.D.

Thursday, 01 November 2007

CANCUN, MEXICO (UroToday.com) - Coverage of the 25th Annual World Congress of Endourology and SWL - Cancun, Mexico - Wednesday October 31st 2007

The authors described for the first time a possible causative mechanism for phenytoin in calculus stone formation. Although this is just a single case report, interestingly, they were able to document phenytoin metabolites in the chemical stone analysis.

The previously documented potential effects of phenytoin on the genitourinary system such as interstitial nephritis, priapism, nephrotic syndrome and acute renal failure have been described previously in literature. This presentation describes the potential lithogenic ability of chronic phenytoin use.

The remarkable feature of this study is that it should arouse the clinician’s level of suspicion once he is confronted with symptomatic patients with renal calculi who have a significant history of phenytoin use.

Session: Stones: Metabolism and Medical Treatment
Moderators: Dean Assimos (USA), Frank Keeley (UK)
Carmin Kalorin, Rass Bauer, Mark White Albany Medical Center

UroToday.com Full Conference Coverage

Reported by UroToday.com Contributing Editor Aldrin Joseph R. Gamboa, MD

Reader Comments

Fellow in Endourology
Written by This email address is being protected from spam bots, you need Javascript enabled to view it on 2007-11-04 01:06:05

Chronic phenytoin and barbiturate use has been found previously in association with osteomalacia, osteodystrophy and nephrolithiasis. The exact mechanism is not known but may be related to hypovitaminosis D. Therefore, it is important to find out if these patients who developed phenytoin calculi actually have coexistent osseous abnormalities which need to be addressed in that they could be life threatening as well.
JOSE BENITO A. ABRAHAM
UC Irvine Fellow in Endourology

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