Ureteropelvic Junction Obstruction and Parathyroid Adenoma: Coincidence or Link?

Salah Termos,Sami Sanjad,Henri Kotobi,Francois Chalard,Majd Alkabbani,Bilal Aoun,Tim Ulinski

doi:10.1155/2017/9852912

Abstract

Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of upper urinary tract obstruction in children. It is generally diagnosed in the routine work-up during antenatal period and is characterized by spontaneous recovery. It can be associated with urolithiasis; hence further investigation should be carried out. We report the case of a 15-year-old boy, who is known to have right UPJO, presented with right renal colic and discovered to have bilateral kidney stones. Further studies showed primary hyperparathyroidism and genetic analysis revealed a CDC73 mutation (initially HRPT2). We believe that association of UPJO and PHPT is a rare coincidence that can be linked. Careful work-up of children with UPJO and urolithiasis is recommended to exclude an underlying metabolic disease. Surgical correction can be evitable as treatment of the primary cause can lead to complete dissolution of kidney stones and improvement of the medical condition.

Highlights

Ureteropelvic junction obstruction (UPJO) has a reported incidence of 1 in 500 live births [1], more commonly in males than females and more frequently found on the left side
We report the case of a 15-year-old boy with a longstanding history of unilateral ureteropelvic junction obstruction who was presented for right flank pain of three-month duration
Because the increased renal pelvic pressure from obstruction may lead to progressive renal injury and impairment, correct diagnosis is clinically important

Summary

Introduction

Ureteropelvic junction obstruction (UPJO) has a reported incidence of 1 in 500 live births [1], more commonly in males than females and more frequently found on the left side. It can be congenital or acquired, but congenital cases are more common. It is considered the most common cause of antenatally detected hydronephrosis [2, 3]. UPJO can lead to urolithiasis due to obstruction and urinary stasis; metabolic causes of urolithiasis should be investigated and ruled out [4,5,6]. We describe an unusual case of UPJO associated with PHTP and kidney stones

Case Presentation

Findings

Discussion