eMedicine Specialties > Pediatrics: General Medicine > Nephrology
Xanthinuria: Follow-up
Updated: Jul 8, 2008
Follow-up
Further Inpatient Care
- Inpatient care may be necessary for the secondary complications of pyelonephritis, obstructive urolithiasis, or acute renal failure.
Further Outpatient Care
- Monitor frequency of symptoms, renal function, and passage of stones.
- Ensure consistent high intake of fluid to maintain dilute urine.
- Monitor purine intake.
Complications
- Urolithiasis
- Crystal nephropathy
- Renal failure
- Obstructive uropathy
- Urinary tract infection
- Hematuria
- Myopathy
- Arthropathy
- Arthritis
Prognosis
- Prognosis depends on the degree of renal injury from crystal nephropathy, urinary obstruction, and/or pyelonephritis.
Patient Education
Advise patients regarding the importance of the following:
- Maintaining a dilute urine
- Avoiding dehydration
- Intervening early for conditions that may lead to dehydration
- Avoiding high-purine foods
- Providing proper home therapy for renal colic
Miscellaneous
Medicolegal Pitfalls
- Failure to consider the diagnosis in a patient with renal colic and evidence of a radiolucent stone
Special Concerns
- Infants and young children may have nonspecific symptoms related to the urinary system, including persistent emesis, irritability, anorexia, poor weight gain, or hematuria.
- Older patients are more likely than children to have muscle symptoms from xanthine and hypoxanthine tissue deposits.
More on Xanthinuria |
| Overview: Xanthinuria |
| Differential Diagnoses & Workup: Xanthinuria |
| Treatment & Medication: Xanthinuria |
Follow-up: Xanthinuria |
| Multimedia: Xanthinuria |
| References |
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References
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Cameron JS, Moro F, Simmonds HA. Gout, uric acid and purine metabolism in paediatric nephrology. Pediatr Nephrol. Feb 1993;7(1):105-18. [Medline].
Carpenter TO, Lebowitz RL, Nelson D, Bauer S. Hereditary xanthinuria presenting in infancy with nephrolithiasis. J Pediatr. Aug 1986;109(2):307-9. [Medline].
Fildes RD. Hereditary xanthinuria with severe urolithiasis occurring in infancy as renal tubular acidosis and hypercalciuria. J Pediatr. Aug 1989;115(2):277-80. [Medline].
Gomez GA, Stutzman L, Chu TM. Xanthine nephropathy during chemotherapy in deficiency of hypoxanthine- guanine phosphoribosyltransferase. Arch Intern Med. Jun 1978;138(6):1017-9. [Medline].
Leimkuhler S, Charcosset M, Latour P, et al. Ten novel mutations in the molybdenum cofactor genes MOCS1 and MOCS2 and in vitro characterization of a MOCS2 mutation that abolishes the binding ability of molybdopterin synthase. Hum Genet. 2005;117(6):565-70. [Medline].
Macaya A, Brunso L, Fernandez-Castillo N, et al. Molybdenum cofactor deficiency presenting as neonatal hyperekplexia: a clinical, biochemical and genetic study. Neuropediatrics.Dec;. 2005;36(6):389-94. [Medline].
Reiter S, Simmonds HA, Zollner N, et al. Demonstration of a combined deficiency of xanthine oxidase and aldehyde oxidase in xanthinuric patients not forming oxipurinol. Clin Chim Acta. Mar 15 1990;187(3):221-34. [Medline].
Simmonds HA, Reiter S, Nishino T. Hereditary xanthinuria. In: The Metabolic and Molecular Bases of Inherited Disease. 1995:1781-97.
Teksam O, Yurdakok M, Coskun T. Molybdenum cofactor deficiency presenting with severe metabolic acidosis and intracranial hemorrhage. J Child Neurol. 2005;20(2):155-7. [Medline].
van Gennip AH, Mandel H, Stroomer LEM. Effects of allopurinol on the xanthinuria in a patient with molybdenum cofactor deficiency. In: Purine and Pyrimidine Metabolism in Man. Vol 8. 1995:375-8.
Zannolli R, Micheli V, Mazzei MA, et al. Hereditary xanthinuria type II associated with mental delay, autism, cortical renal cysts, nephrocalcinosis, osteopenia, and hair and teeth defects. J Med Genet. Nov 2003;40(11):e121. [Medline].
Further Reading
Keywords
xanthinuria, classic xanthinuria, hereditary xanthinuria, iatrogenic xanthinuria, xanthuria, xanthiuria, xanthine in the urine, arthropathy, myopathy, crystal nephropathy, urolithiasis, renal failure, microcephaly, hyperreflexia, Lesch-Nyhan syndrome, xanthine nephropathy, acute kidney failure, hematuria, interstitial nephritis, chronic renal failure, end-stage renal disease, arthritis, arthralgia, renal colic, urinary tract infection, urolithiasis
Follow-up: Xanthinuria