Plawecki Maëlle, Bistoquet Marie, Grillet Pierre-Edouard, Abdo Nicolas, Souweine Jean-Sébastien, Cristol Jean-Paul
Department of Biochemistry, CHU Montpellier, Montpellier, France.
PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier University Hospital, Montpellier, France.
Case Rep Urol. 2023 Mar 29;2023:4890711. doi: 10.1155/2023/4890711. eCollection 2023.
A HIV-infected female treated with a combination of emtricitabine/elvitegravir/tenofovir since 2017 presented an acute renal failure during her hospitalization for a SARS-CoV2 pneumonia. A computed tomography demonstrated left ureterohydronephrosis and ureteral stone. Fragments extracted by ureteroscopy showed a calculus composed of atazanavir and calcium oxalate. The patient's medical history showed atazanavir intake during ten years and then discontinued in 2017. This case report emphasizes that drug-induced urolithiasis should be considered when renal function declines, even far from discontinuation of atazanavir and without clinical signs of renal colitis. Moreover, identification of risk factors should alert to the possibility of drug-induced nephrolithiasis.
一名自2017年起接受恩曲他滨/埃替格韦/替诺福韦联合治疗的HIV感染女性,在因SARS-CoV2肺炎住院期间出现急性肾衰竭。计算机断层扫描显示左输尿管肾盂积水和输尿管结石。输尿管镜取出的碎片显示结石由阿扎那韦和草酸钙组成。患者病史显示服用阿扎那韦十年,于2017年停药。本病例报告强调,即使在远离停用阿扎那韦且无肾绞痛临床体征的情况下,当肾功能下降时也应考虑药物性尿石症。此外,识别风险因素应警惕药物性肾结石的可能性。