CASE PROFILE:
HORSESHOE PATIENT
KIDNEY
WITH CALCULI
WITH SARCOIDOSIS
NOTE - Urograms of interest to our readers are welcome from tributions, including an abbreviated history and legendfor thejlms, M.D., feature editor.
1 PROFILE
A forty-nine-year-old black male was admitted to University Hospitals of Cleveland with left flank pain and sepsis. The patient has had sarcoidosis for twenty-two years and has required steroids for progressive sarcoid myopathy. Hypercalciuria as well as urinary tract infections had been docu-
FIGURE 1. (A) Excretory urogram demonstrating later demonstrating calculi obstructing left ureter
608
IN
urologists and radiologists. Conare to be sent to Arthur N. Tessler,
1
mented on several occasions during this long illness. Excretory urogram obtained twenty years earlier demonstrated a horseshoe kidney; no calculi were evident (Fig. 1A). Roentgenogram on admission revealed calculi filling the distal half of the left ureter and a large staghorn calculus
horseshoe kidney. (B) Roentgenogram obtained twenty years and staghorn calculus filling right renal pelvis and calyces.
UROLOGY
/ DECEMBER
1976 / VOLUME
VIII,
NUMBER 6
FIGURE
prompt
(A) Postoperative
2.
excretion
of contrast
roentgenogram; calculi have been removed. material bilaterally with no obstruction.
lodged in the right renal pelvis and calyces (Fig. 1B). There was nonvisualization of the left kidney after the injection of contrast material. An extensive left ureterolithotomy was performed, and five large calculi were removed. Four weeks later the patient underwent an extended right pyelolithotomy to remove the staghorn calculus. Postoperative x-ray films documented removal of all calculi (Fig. 2). Hypercalcemia and hypercalciuria occur in approximately 20 per cent of patients with sarcoidosis and are thought to be due to an increased absorption of calcium from the gastrointestinal
L:ROL,O(:Y
/
1IECEZIBER
1976
/
tract as a result vitamin D.
VOLUhlE VIII, NUMBER 6
(B) Postoperative
urogram
of a heightened
revealing
sensitivity
to
Mark S. Soloway, M.D. Department of Urology University of Tennessee Center for the Health Sciences Memphis, Tennessee 38163 Gerald Herman, M.D. Knute Guerrier, M.D. Lester Persky, M.D. Division of Urology University Hospitals of Cleveland Cleveland, Ohio
HORSESHOE PATIENT
KIDNEY
WITH CALCULI
WITH SARCOIDOSIS
NOTE - Urograms of interest to our readers are welcome from tributions, including an abbreviated history and legendfor thejlms, M.D., feature editor.
1 PROFILE
A forty-nine-year-old black male was admitted to University Hospitals of Cleveland with left flank pain and sepsis. The patient has had sarcoidosis for twenty-two years and has required steroids for progressive sarcoid myopathy. Hypercalciuria as well as urinary tract infections had been docu-
FIGURE 1. (A) Excretory urogram demonstrating later demonstrating calculi obstructing left ureter
608
IN
urologists and radiologists. Conare to be sent to Arthur N. Tessler,
1
mented on several occasions during this long illness. Excretory urogram obtained twenty years earlier demonstrated a horseshoe kidney; no calculi were evident (Fig. 1A). Roentgenogram on admission revealed calculi filling the distal half of the left ureter and a large staghorn calculus
horseshoe kidney. (B) Roentgenogram obtained twenty years and staghorn calculus filling right renal pelvis and calyces.
UROLOGY
/ DECEMBER
1976 / VOLUME
VIII,
NUMBER 6
FIGURE
prompt
(A) Postoperative
2.
excretion
of contrast
roentgenogram; calculi have been removed. material bilaterally with no obstruction.
lodged in the right renal pelvis and calyces (Fig. 1B). There was nonvisualization of the left kidney after the injection of contrast material. An extensive left ureterolithotomy was performed, and five large calculi were removed. Four weeks later the patient underwent an extended right pyelolithotomy to remove the staghorn calculus. Postoperative x-ray films documented removal of all calculi (Fig. 2). Hypercalcemia and hypercalciuria occur in approximately 20 per cent of patients with sarcoidosis and are thought to be due to an increased absorption of calcium from the gastrointestinal
L:ROL,O(:Y
/
1IECEZIBER
1976
/
tract as a result vitamin D.
VOLUhlE VIII, NUMBER 6
(B) Postoperative
urogram
of a heightened
revealing
sensitivity
to
Mark S. Soloway, M.D. Department of Urology University of Tennessee Center for the Health Sciences Memphis, Tennessee 38163 Gerald Herman, M.D. Knute Guerrier, M.D. Lester Persky, M.D. Division of Urology University Hospitals of Cleveland Cleveland, Ohio
