Successful endourological treatment for a rare case of atazanavir-induced urinary stones

Q4 Medicine

IJU Case Reports Pub Date : 2024-08-30 DOI:10.1002/iju5.12779

Takehiro Nakamura, Ryoji Takazawa, Yosuke Umino

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Abstract

Introduction

Atazanavir, an anti-HIV drug, induces urinary stone formation. We herein report a case of atazanavir-induced bilateral ureteral stones treated with endourological procedures.

Case presentation

A 47-year-old male patient on atazanavir was admitted with right flank pain. The patient's serum creatinine level was 3.60 mg/dL. Plain computed tomography showed bilateral hydronephrosis. The left upper ureter was obstructed by a 13 × 12 × 9-mm mass, which had very low CT attenuation values. The lower part of the right ureter was obstructed, but no mass was observed. Given his medical history, we suspected bilateral ureteral obstruction caused by drug-induced stones. A ureteral stent was successfully inserted on the right side, but not on the left side. Thereafter, a bilateral ureteroscopic lithotripsy was performed. Infrared spectrophotometry revealed that the stone component was atazanavir.

Conclusion

Understanding the characteristics of these rare drug-induced stones will aid in the proper early diagnosis and treatment.

Abstract Image

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对一例罕见的阿扎那韦引起的泌尿系结石进行了成功的腔内治疗。

简介阿扎那韦是一种抗艾滋病毒药物，可诱发泌尿系结石形成。我们在此报告一例阿扎那韦诱发的双侧输尿管结石病例，该病例经内镜手术治疗：一名服用阿扎那韦的 47 岁男性患者因右腹部疼痛入院。患者的血清肌酐水平为 3.60 毫克/分升。计算机断层扫描平片显示双侧肾积水。左侧输尿管上段被一个 13 × 12 × 9 毫米的肿块阻塞，该肿块的 CT 衰减值很低。右侧输尿管下段阻塞，但未发现肿块。考虑到他的病史，我们怀疑双侧输尿管梗阻是由药物引起的结石造成的。我们成功地为他植入了右侧输尿管支架，但没有植入左侧。随后，进行了双侧输尿管镜碎石术。红外分光光度法显示，结石成分为阿扎那韦：结论：了解这些罕见药物性结石的特征有助于早期诊断和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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