Document Detail


Nephrotic syndrome occurring during tiopronin treatment for cystinuria.
MedLine Citation:
PMID:  20924604     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Cystinuria is an autosomal recessive disorder characterized with abnormal tubular reabsorption of cystine and dibasic amino acids leading to cystine urolithiasis. The classical form is caused by mutations in the SLC3A1 gene (OMIM 220100). The cornerstone of the treatment is high hydration and alkalization of the urine to achieve urine pH between 7.0 and 7.5, at which point, cystine solubility in the urine is optimal. These measures very often fail, and thus addition of sulfhydryl agents like penicillamine and tiopronin (mercaptopropionyl glycine) is recommended. Herein, we report a 3-year-old boy with cystinuria resulting in recurrent nephrolithiasis requiring surgery and extracorporeal shock wave lithotripsy. Nine months after introduction of tiopronin, the boy manifested generalized edema, oliguria, and biochemical indices of nephrotic syndrome. Tiopronin was withdrawn, and the boy was given only supportive treatment. Within 10 days, he entered into clinical and biochemical remission. Pediatricians should be aware of this adverse effect of tiopronin, and therefore, testing of the urine with strips or sulfosalicylic acid at least once weekly at home may be very helpful for early detection of proteinuria.
Authors:
Velibor Tasic; Vladimir J Lozanovski; Nadica Ristoska-Bojkovska; Emilija Sahpazova; Zoran Gucev
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Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  European journal of pediatrics     Volume:  170     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  247-9     Citation Subset:  IM    
Affiliation:
University Children's Hospital, Medical School Skopje, 17 Vodnjanska, 1000, Skopje, Macedonia, vtasic2003@gmail.com.
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