Primary Hyperoxaluria Type 1 with Thrombophilia in Pregnancy: A Case Report
Background: Primary hyperoxaluria type 1 (PH1) is a rare autosomal recessive disease caused by a mutation in the AGXT gene, resulting in deficiency of the alanineglyoxylate:aminotrans-ferase enzyme. It is characterized by accumulation of oxalate in the kidneys and other organs.
Case Presentation: A Syrian woman with a history of nephrolithiasis and heterozygosity for factor V Leiden and prothrombin gene mutations presented with postpartum renal failure. She required initiation of renal replacement therapy at 14 weeks postpartum. Kidney biopsy showed severe acute and chronic crystalline deposition consistent with oxalate nephropathy. Genetic testing revealed a Gly170Arg mutation in the AGXT gene, confirming the diagnosis of PH1.
Conclusions: The diagnosis of PH should be considered in patients with severe, recurrent calcium oxalate nephrolithiasis. Early treatment with pyridoxine reduces urinary oxalate excre-tion and can delay progression to end-stage renal disease (ESRD). After ESRD, intensive dialysis is needed to prevent systemic oxalate accumulation and deposition. Combined liver and kid-ney transplantation is curative. In our patient, we anticipate that liver transplantation will cure both the hyperoxaluria and the hypercoagulable state
Published In/Presented At
Hasan, A. Maynard, S. E., Santoriello, D. Schairer, H. (2018). Primary Hyperoxaluria Type 1 with Thrombophilia in Pregnancy: A Case Report. Case Reports in Nephrology and Dialysis.8 223-229. https://doi.org/10.1159/000493091 .
Department of Medicine, Department of Medicine Faculty