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See detailMeeting report of the "Symposium on kidney stones and mineral metabolism: calcium kidney stones in 2017"
Pozdzik, Agnieszka; Maalouf, Naim; Letavernier, Emmanuel et al

in Journal of Nephrology (2019)

A symposium on kidney stones and mineral metabolism held on December 2017 in Brussels, Belgium was the first international multidisciplinary conference of the International Collaborative Network on Kidney ... [more ▼]

A symposium on kidney stones and mineral metabolism held on December 2017 in Brussels, Belgium was the first international multidisciplinary conference of the International Collaborative Network on Kidney Stones and Mineral Metabolism. This meeting addressed epidemiology, underlying pathophysiological mechanisms, genetics, pathological, as well as clinical and research topics. The participants included clinicians and recognized experts in the field from Europe and the United States interacted closely during the symposium which promoted a chance to explore new frontiers in the field of kidney stone disease. This manuscript summarizes some of the major highlights of the meeting. [less ▲]

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See detailRaman chemical imaging, a new tool in kidney stone structure analysis: Case-study and comparison to Fourier Transform Infrared spectroscopy
Castiglione, Vincent ULiege; Sacre, Pierre-Yves ULiege; Cavalier, Etienne ULiege et al

Poster (2018, November 16)

The kidney stone’s structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two- dimension maps of the ... [more ▼]

The kidney stone’s structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two- dimension maps of the constituents’ distribution in samples. We aimed at determining the use of Raman chemical imaging in urinary stone analysis. Fourteen calculi were analyzed by Raman chemical imaging using a confocal Raman micro- spectrophotometer. They were selected according to their heterogeneous composition and morphology. Raman chemical imaging was performed on the whole section of stones. Once acquired, the data were baseline corrected and analyzed by MCR-ALS. Results were then compared to the spectra obtained by Fourier Transform Infrared spectroscopy. [less ▲]

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See detailDiagnostic accuracy of three automated urine analyzers compared to urine culture
Castiglione, Vincent ULiege; GADISSEUR, Romy ULiege; Bernard, Maxime ULiege et al

Poster (2018, November 16)

Urine culture is an important diagnosis method of urinary tract infection. However, it is time-consuming and results aren’t available quickly. Automated urine analyzers have been developed to screen urine ... [more ▼]

Urine culture is an important diagnosis method of urinary tract infection. However, it is time-consuming and results aren’t available quickly. Automated urine analyzers have been developed to screen urine samples more rapidly. The goal of this study was to compare three automated analyzers to urine culture: the Atellica UAS 800 (Siemens, Munich, Germany), the UF-4000 (Sysmex, Kobe, Japan) and the SediMAX (Menarini, Florence, Italy). We first validated each analyzer. We analyzed then 318 samples with the three analyzers within 2 hours after sample reception. An urine aliquot was collected before sediment analysis for bacteria culture. Ten microliters of un-centrifuged urine was inoculated on blood agar and CLED agar plates, then they were incubated aerobically at 36°C for 24 h. Bacteria count of each analyzer was compared to urine culture to determine diagnostic accuracy. The result was considered positive when the bacteria growth reached 104 CFU/ml. We also used the results of leukocytes and nitrites results from the strip measurement to improve the accuracy. The abilities of the UF-4000 to distinguish Gram positive (GP) from Gram negative (GN) bacteria, and of the UAS 800 to identify rod and cocci, were determined. [less ▲]

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See detailUrine sediment analysis: comparison of three automated analyzers to manual microscopy
Castiglione, Vincent ULiege; GADISSEUR, Romy ULiege; Bernard, Maxime ULiege et al

Poster (2018, November 16)

Urine microscopic analysis is an old method that reveals information about kidney health. Several automated analyzers, that are less time-consuming, are currently available, but manual microscopy is still ... [more ▼]

Urine microscopic analysis is an old method that reveals information about kidney health. Several automated analyzers, that are less time-consuming, are currently available, but manual microscopy is still the gold-standard method. The goal of this study was to validate and compare three automated analyzers to manual microscopy: the Atellica UAS800 (Siemens, Munich, Germany), the UF-4000 (Sysmex, Kobe, Japan) and the SediMax (Menarini, Florence, Italy). We first validated each analyzer. A total of 359 samples were analyzed with the three analyzers and with a manual microscope within 2 hours. Two trained reviewers used a microscope with bright field, contrast phase and polarized light to identify urine elements. The diagnostic accuracy was determined thanks to microscopy results. [less ▲]

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See detailComparison of three automated strip analyzers to Cobas 800 for the analysis of glucose, proteins, albumin and creatinine
Castiglione, Vincent ULiege; GADISSEUR, Romy ULiege; Bernard, Maxime ULiege et al

Poster (2018, November 16)

Urine glucose, proteins, albumin and creatinine are measured for the screening of diabetes and renal diseases. The automated strip analyzers are used for quick screening of large populations. The goal of ... [more ▼]

Urine glucose, proteins, albumin and creatinine are measured for the screening of diabetes and renal diseases. The automated strip analyzers are used for quick screening of large populations. The goal of this study was to compare a more accurate method, the Cobas 8000 (Roche, Bale, Switzerland) to three automated analyzers: the Clinitek Novus (Siemens, Munich, Germany), the UC-3500 (Sysmex, Kobe, Japan) and the AutionMax (Menarini, Florence, Italy). A total of 284 urine samples were prospectively collected for the comparison. The samples were analyzed on the three analyzers within 2 hours. Before the analysis of samples by each method, an aliquot was frozen at -80°C. All samples were then defrost and analyzed in one batch with the Cobas 8000 (Roche, Bale, Switzerland) within the month. The diagnostic accuracy was determined thanks to the results of the Cobas 8000. However, the creatinine and albumin cannot be assessed with the AutionMax. [less ▲]

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See detailClinical data on rare Sulfamethoxazole crystalluria assessed by Fourier Transform Infrared Spectrophotometry
CASTIGLIONE, Vincent ULiege; CAVALIER, Etienne ULiege; GADISSEUR, Romy ULiege

in Data in Brief (2018)

The data contained in this article are related to the article entitled “Case report: Uncommon Sulfamethoxazole Crystalluria” [1]. Sulfamethoxazole crystalluria is very rare and crystals identification is ... [more ▼]

The data contained in this article are related to the article entitled “Case report: Uncommon Sulfamethoxazole Crystalluria” [1]. Sulfamethoxazole crystalluria is very rare and crystals identification is complex [2], [3]. We identified seven patients with uncommon urine crystals that were composed of N-Acetyl-Sulfamethoxazole. Three of the patients developed an acute renal failure simultaneously to crystalluria. Hence, this article describes the method of crystals identification thanks to infrared spectroscopy. The relevant clinical data of patients, including medical history, drug dosage and urine parameters related to the crystalluria are presented. [less ▲]

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See detailMatrix-Gla-Protein: un nouveau marqueur de lithiase urinaire?
Castiglione, Vincent ULiege; DELANAYE, Pierre ULiege; LUKAS, Pierre ULiege et al

Conference (2018, October 19)

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See detailUrine sediment analysis: comparison of three automated analyzers
Castiglione, Vincent ULiege; GADISSEUR, Romy ULiege

Conference (2018, October 09)

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See detailRaman Chemical Imaging, a new tool in kidney stone structure analysis: Case-study and comparison to Fourier Transform Infrared spectroscopy
Castiglione, Vincent ULiege; Sacre, Pierre-Yves ULiege; CAVALIER, Etienne ULiege et al

in PLoS ONE (2018), 13(8), 0201460

Background and objectives: The kidney stone’s structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two ... [more ▼]

Background and objectives: The kidney stone’s structure might provide clinical information in addition to the stone composition. The Raman chemical imaging is a technology used for the production of two-dimension maps of the constituents' distribution in samples. We aimed at determining the use of Raman chemical imaging in urinary stone analysis. Material and methods: Fourteen calculi were analyzed by Raman chemical imaging using a confocal Raman microspectrophotometer. They were selected according to their heterogeneous composition and morphology. Raman chemical imaging was performed on the whole section of stones. Once acquired, the data were baseline corrected and analyzed by MCR-ALS. Results were then compared to the spectra obtained by Fourier Transform Infrared spectroscopy. Results: Raman chemical imaging succeeded in identifying almost all the chemical components of each sample, including monohydrate and dihydrate calcium oxalate, anhydrous and dihydrate uric acid, apatite, struvite, brushite, and rare chemicals like whitlockite, ammonium urate and drugs. However, proteins couldn't be detected because of the huge autofluorescence background and the small concentration of these poor Raman scatterers. Carbapatite and calcium oxalate were correctly detected even when they represented less than 5 percent of the whole stones. Moreover, Raman chemical imaging provided the distribution of components within the stones: nuclei were accurately identified, as well as thin layers of other components. Conversion of dihydrate to monohydrate calcium oxalate was correctly observed in the centre of one sample. The calcium oxalate monohydrate had different Raman spectra according to its localization. Conclusion: Raman chemical imaging showed a good accuracy in comparison with infrared spectroscopy in identifying components of kidney stones. This analysis was also useful in determining the organization of components within stones, which help locating constituents in low quantity, such as nuclei. However, this analysis is time-consuming, making it more suitable for research studies rather than routine analysis. [less ▲]

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See detailElucidation de la structure de la lithiase urinaire par imagerie IR-TF
Coic, Laureen ULiege; Castiglione, Vincent ULiege; Sacre, Pierre-Yves ULiege et al

Poster (2018, May)

Les lithiases urinaires sont des concrétions minérales qui se forment au niveau des reins. En fonction de leur taille et de leur composition, leur présence peut être un signe avant-coureur de maladies ... [more ▼]

Les lithiases urinaires sont des concrétions minérales qui se forment au niveau des reins. En fonction de leur taille et de leur composition, leur présence peut être un signe avant-coureur de maladies graves. Elles sont généralement analysées par spectroscopie Infrarouge à transformée de Fourier (IR-TF). La structure de la lithiase apporte des informations de l’évolution de la lithiase au court du temps. Celle-ci a des conséquences cliniques qui permettent d’améliorer la qualité des soins apportés au patient. Or, cette structure n’est pas élucidable par l’analyse conventionnelle en IR-TF car la lithiase est broyée pour pouvoir l’analyser ne donnant donc qu’une information moyenne de la composition. Le couplage de l’imagerie avec la spectroscopie IR-TF apporte un réel intérêt pour élucider la structure de la lithiase urinaire car c’est une technique non destructive et relativement rapide (temps d’analyse moyen par lithiase < 3h). Pour réaliser l’étude, onze lithiases avec des compositions chimiques différentes ont été sélectionnées puis analysées par imagerie IR-TF en réflexion (DRIFTS). Les images ont été acquises avec une résolution latérale de 5.5 µm et une résolution spectrale de 4 cm-1. Les données hyperspectrales obtenues ont été prétraitées avec une correction de ligne de base de type Whittaker. Les spectres des différents composés et les cartes de distribution afférentes ont été obtenus par décomposition des images à l’aide de la MCR-ALS. Les images IR permettent d’identifier la totalité des composés présents dans les lithiases avec une corrélation spectrale de plus de 0,90 pour l’ensemble des molécules. Dans certains cas, l’imagerie permet de mettre en exergue la présence de composés qui n’avaient pas été détectés par spectroscopie IR conventionnelle. Les images obtenues par MCR-ALS permettent de discriminer l’oxalate de calcium monohydraté (Whewhellite) de l’oxalate de calcium dihydraté (Weddellite) qui étaient pour alors difficilement discernables par spectroscopie. L’identification des protéines est également possible lorsqu’elles sont présentes à plus de 10% de la surface de la lithiase. L’imagerie IR montre ainsi un fort potentiel dans l’évaluation qualitative de la composition et de la structure de la lithiase urinaire et pourrait être transposée à d’autres applications métabolomiques. [less ▲]

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See detailCase report: Uncommon Sulfamethoxazole Crystalluria
Castiglione, Vincent ULiege; CAVALIER, Etienne ULiege; GADISSEUR, Romy ULiege

in Clinical Biochemistry (2018)

We report seven Caucasian patients with unusual Sulfamethoxazole crystalluria on random urine sediment analysis. Crystals had very uncommon and various shapes and were identified thanks to infrared ... [more ▼]

We report seven Caucasian patients with unusual Sulfamethoxazole crystalluria on random urine sediment analysis. Crystals had very uncommon and various shapes and were identified thanks to infrared spectroscopy. An eGFR (MDRD) decrease was associated to crystalluria onset in three patients. [less ▲]

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See detailEpidemiology of urolithiasis in Liège according to morpho-constitutional classification
Castiglione, Vincent ULiege

Conference (2017, December 08)

Background Stone components are various and influenced by acquired and inherited factors. Hence we describe the distribution of stone composition in Belgium according to age and sex. Methods We ... [more ▼]

Background Stone components are various and influenced by acquired and inherited factors. Hence we describe the distribution of stone composition in Belgium according to age and sex. Methods We retrospectively reviewed 1869 urinary stones analyzed between 2010 and 2013 at the laboratory of the CHU of Liège (Belgium). Samples were assessed by infrared spectroscopy, and morphology was used to classify stones in morpho-constitutional types according to Daudon classification. Results Among 1869 stones, 69.2% affected men. The prevalence peak was observed between 50–60 years of age in both genders. The main constituent was calcium oxalate monohydrate (54.4%), mainly organized as type Ia (94%). Calcium oxalate dihydrate was found in 19.8% samples, with an equal distribution between types IIa and IIb. Uric acid was the 3rd most frequent constituent in man (10.8%), instead of phosphates in woman (26.6%). Urinary infection may be the main cause of stone formation in 6% of patients. Multiple morphological types were concomitantly identified in 49.3% of stones. The proportion of calcium oxalate dihydrate stones decreased with aging, while monohydrate and uric acid increased in both genders. Conclusion This retrospective analysis of urinary stones helps for the first time to characterize the epidemiology of urolithiasis in Belgium. [less ▲]

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See detailOral calcium load test for recurrent calcium stone-formers
Castiglione, Vincent ULiege; CAVALIER, Etienne ULiege

Poster (2017, November 24)

Background Calcium is the most frequent component of urinary stones, and hypercalciuria is the main risk factor in recurrent stone-formers. The oral calcium load test is a dynamical biological test that ... [more ▼]

Background Calcium is the most frequent component of urinary stones, and hypercalciuria is the main risk factor in recurrent stone-formers. The oral calcium load test is a dynamical biological test that determines the origin of hypercalciuria in order to optimize the treatment. However, there is little literature about it, and it seems to have lost popularity in daily practice, this why we studied a population of stone-formers who underwent the oral calcium load test. Methods Between 2013 and 2016, we prospectively recruited 117 recurrent calcium stone-formers. After 2 days of calcium restricted-diet, patients had urinary and blood sampling at baseline and 120 min after the intake of 1 g of calcium per os. Blood and urinary parameters were assessed during the dynamical test, including stone risk factors, calcium metabolism and bone evaluation. According to these results, patients were classified in three groups: resorptive, renal or absorptive hypercalciuria. Results First, 19 patients were diagnosed with normocalcemic primary hyperparathyroidism, assessed by inappropriate parathormone decrease (41.41±12.82 vs. 54.06±13.84% p<0.01) in regard to calcemia. The measurement of ionized calcium was mandatory in order to detect induced hypercalcemia after calcium intake. These patients also had higher beta-crosslaps, lower phosphate reabsorption threshold and lower distal third radius bone mineral density. The treatment of this first group of patient is the hyperparathyroïdectomy. Fasting hypercalciuria was present in 39 patients with urinary calcium >0.37mmol/mmol of creatinine, and without hyperparathyroidism, classified thus as renal hypercalciuria. The treatment of these patients should include adapted calcium intake and thiazids. The third group included 34 patients with absorptive hypercalciuria defined by the presence of delta urinary calcium/creatinine <0.6mmol/mmol between 0 and 120 min, and without any other significant abnormality. Finally, the test result was not reliable for 33 cases because of the absence of sufficient calcemia increase or when the cause of lithogenesis could not be clearly identified. Conclusions The oral calcium load test was successful for the identification of main metabolic conditions leading to urolithiasis, including normocalcemic primary hyperparathyroidism, and is useful to improve and personalize the treatment of stone-formers. [less ▲]

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See detailOral calcium load test for recurrent calcium stone-formers
Castiglione, Vincent ULiege; CAVALIER, Etienne ULiege

Conference (2017, November 24)

Background Calcium is the most frequent component of urinary stones, and hypercalciuria is the main risk factor in recurrent stone-formers. The oral calcium load test is a dynamical biological test that ... [more ▼]

Background Calcium is the most frequent component of urinary stones, and hypercalciuria is the main risk factor in recurrent stone-formers. The oral calcium load test is a dynamical biological test that determines the origin of hypercalciuria in order to optimize the treatment. However, there is little literature about it, and it seems to have lost popularity in daily practice, this why we studied a population of stone-formers who underwent the oral calcium load test. Methods Between 2013 and 2016, we prospectively recruited 117 recurrent calcium stone-formers. After 2 days of calcium restricted-diet, patients had urinary and blood sampling at baseline and 120 min after the intake of 1 g of calcium per os. Blood and urinary parameters were assessed during the dynamical test, including stone risk factors, calcium metabolism and bone evaluation. According to these results, patients were classified in three groups: resorptive, renal or absorptive hypercalciuria. Results First, 19 patients were diagnosed with normocalcemic primary hyperparathyroidism, assessed by inappropriate parathormone decrease (41.41±12.82 vs. 54.06±13.84% p<0.01) in regard to calcemia. The measurement of ionized calcium was mandatory in order to detect induced hypercalcemia after calcium intake. These patients also had higher beta-crosslaps, lower phosphate reabsorption threshold and lower distal third radius bone mineral density. The treatment of this first group of patient is the hyperparathyroïdectomy. Fasting hypercalciuria was present in 39 patients with urinary calcium >0.37mmol/mmol of creatinine, and without hyperparathyroidism, classified thus as renal hypercalciuria. The treatment of these patients should include adapted calcium intake and thiazids. The third group included 34 patients with absorptive hypercalciuria defined by the presence of delta urinary calcium/creatinine <0.6mmol/mmol between 0 and 120 min, and without any other significant abnormality. Finally, the test result was not reliable for 33 cases because of the absence of sufficient calcemia increase or when the cause of lithogenesis could not be clearly identified. Conclusions The oral calcium load test was successful for the identification of main metabolic conditions leading to urolithiasis, including normocalcemic primary hyperparathyroidism, and is useful to improve and personalize the treatment of stone-formers. [less ▲]

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See detailRare Sulfamethoxazole Crystalluria – case report
Castiglione, Vincent ULiege; Diop, Coumba Souley ULiege; CAVALIER, Etienne ULiege et al

Poster (2017, November 24)

Case discussion We report here 7 Caucasian patients with very uncommon crystalluria. There were 3 female and 4 male of 54 to 86 years-old. Patients had no relevant medical record in common. However, they ... [more ▼]

Case discussion We report here 7 Caucasian patients with very uncommon crystalluria. There were 3 female and 4 male of 54 to 86 years-old. Patients had no relevant medical record in common. However, they all were hospitalized for different types of infections: three patients had urinary infection, two had osteitis, and the two last had sepsis. The patients had all been first treated with different antibiotherapy, which had then been replaced by cotrimoxazole after antibiogram. The administrated doses varied from 800mg to 4800mg a day of Sulfamethoxazole. Crystalluria description In all patients, the urine microscopic analysis revealed unusual crystals of various shapes including rectangles, thick parallelepipeds, truncated lozenges, spheroids, mushrooms, or “flowers”. Some crystals were incorrectly identified by the urinary sediment analyzer as uric acid, but we sought to determine them accurately. Most of the crystals were strongly birefringent and measured between 20 and 100µm. Urine pH varied from 5.0 to 6.5 on strip analysis. After urine centrifugation, we performed infrared spectrophotometry analysis on dried residue. In all cases, the infrared spectra allowed us to identify the N-acetyl-Sulfamethoxazole, the main metabolite of Sulfamethoxazole. Crystalluria was observed between 1 and 26 days after Sulfamethoxazole treatment initiation. The serum creatinine increased from 16% to 88% in 3 patients between the first day of Sulfamethoxazole treatment and the day of crystalluria. These considerations raised concern for drug implication in renal failure in some of these patients. Teaching points for the clinical condition Drug-induced kidney failure is well-known, but the direct precipitation of drug crystals into tubules is rare, and also probably under-evaluated. Even if Sulfamethoxazole tubular precipitation was probably not the main cause of renal failure in these cases, we suspect it could have played a role. N-Acteyl-Sulfamethoxazole can precipitate in urine in many uncommon crystals shapes that raise suspicion for drug nephrotoxicity. Automated urine analyzers may misidentify these rare crystals. Crystal’s recognition may be difficult even with polarized light microscopy. This is why they must be identified by infrared spectrophotometry to avoid misdiagnosis. These renal failures linked to Sulfamethoxazole precipitation are more susceptible to appear with high dosage of drug, hypovolemia and pre-existing renal failure. Hypoalbuminemia has also been described as a risk factor and was present in our four patients (between 26 to 39g/l, range laboratory: 43-54). Thus, prevention of Sulfamethoxazole precipitation consists in hydratation to maintain urine flow, and require adaptation of cotrimoxazole dosage in regard of renal function. Urine alkalinization (pH >7.0) is also possible in order to increase Sulfamethoxazole metabolite solubility. [less ▲]

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See detailRaman Chemical Imaging in Kidney Stone Analysis
Castiglione, Vincent ULiege; Sacre, Pierre-Yves ULiege; CAVALIER, Etienne ULiege et al

Poster (2017, November 02)

Background: The structure of kidney stones might provide clinical useful information in addition to the stone composition. The Raman chemical imaging (RCI) is a new technology used for the production of ... [more ▼]

Background: The structure of kidney stones might provide clinical useful information in addition to the stone composition. The Raman chemical imaging (RCI) is a new technology used for the production of two-dimensions maps of the constituents' distribution in samples. We aimed at determining the use of RCI in urinary stone analysis. Methods: Twelve calculi were analyzed by RCI using a confocal Raman microspectrophotometer. They were selected according to their heterogeneous composition and morphology. Prior to the analysis, samples were sliced and milled in order to detect the nucleus of the stones and having a smooth surface. RCI was performed on the whole section of stones. Once acquired, the data were baseline corrected and analyzed by MCR-ALS. Results were then compared to the spectra obtained by Fourier Transform Infrared spectroscopy, the gold standard method for the determination of urolithiasis composition. Results: RCI succeeded in identifying all the chemical components contained in each sample, including monohydrate and dihydrate calcium oxalate, anhydrous and dihydrate uric acid, apatite, struvite, brushite, whitlockite and ammonium urate. However, proteins couldn't be detected because of the huge autofluorescence background and the small concentration of these poor Raman scatterers. Carbapatite and calcium oxalate were correctly detected even when they represented less than 5 percent of the whole stones, allowing the detection of very small structures like Randall's plaques. Moreover, RCI provided the distribution of components within the stones. The nuclei were accurately identified, as well as thin layers of other components. Conversion of dihydrate to monohydrate calcium oxalate was correctly observed in the center of one sample. Conclusion: RCI showed a good accuracy in comparison with infrared spectroscopy in identifying components of kidney stones. In addition, RCI is nondestructive enabling the storage of samples. This analysis was also useful in determining the organization of components within stones, which help locating constituents in low quantity, such as nuclei. However, this analysis is time-consuming, which makes it more suitable for research studies rather than routine analysis. [less ▲]

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See detailHyperoxalurie primaire et calculs de Caoxite - Case report
Castiglione, Vincent ULiege

Conference (2017, October 20)

Nous décrivons ici le cas d’un patient de 21 ans atteint d’hyperoxalurie primaire de type I suivi depuis 2015 au CHU de Liège. Le diagnostic a été confirmé chez le patient dès ses 3ans par test génétique ... [more ▼]

Nous décrivons ici le cas d’un patient de 21 ans atteint d’hyperoxalurie primaire de type I suivi depuis 2015 au CHU de Liège. Le diagnostic a été confirmé chez le patient dès ses 3ans par test génétique. Les mutations en cause sont c.969-3C>G et c.725C>A, laissant une activité résiduelle de l’alanine glyoxylate aminotransférase estimée à 3%. L’oxalurie de 24h était comprise entre 100 et 170mg/g de créatinine lors des dernières biologies. Le traitement médicamenteux inclus de la pyridoxine (2x250mg/j) et du citrate de potassium (+/-10g/j). Une sonde de gastrotomie a également été instaurée pour gavage hydrique nocturne. Le patient a subi plus de 12 interventions urologiques au cours des 3 années précédentes. Aussi, la fonction rénale a progressivement décliné en passant de >60 à 40mL/min/1.73m² notamment à cause de la compliance difficile au traitement. Aucune manifestation extrarénale de l’oxalose n’est encore survenue. L’analyse infrarouge des calculs de 2015 et 2016 renseignaient une composition exclusive de Whewellite. L’analyse morphologique identifiait initialement des calculs de type Ia, mais plus récemment, ceux-ci ont commencé à prendre une structure inhabituelle moins organisée. Les derniers calculs expulsés en 2017 présentaient quant à eux un faciès bien particulier avec de grands cristaux anguleux aux angles non quadratiques. L’analyse infrarouge a permit de détecter la présence de Caoxite (oxalate de calcium trihydraté) au sein de deux séries de calculs. En guise de confirmation, une étude de la cristallurie a mis en évidence des cristaux au faciès typique de la caoxite. La formation de ces calculs particuliers pourrait être associée à plusieurs éléments, comme la prise de bicarbonate de calcium accompagnée d’une hypercalcémie (malgré une calciurie basse inférieure à 3mg/24h). Aussi, la baisse de la fonction rénale et une augmentation de la citraturie de 24h étaient concomitants. Par contre, aucune augmentation significative de l’oxalurie n’a pu être observée. Les mécanismes précis ayant menés à la précipitation de caoxite restent flous, sachant que ce composé n’a à notre connaissance, été décrit que lors de la prise de glyoxylate. [less ▲]

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See detailQuel est l'intérêt du test de Pak chez les patients lithiasiques?
Castiglione, Vincent ULiege

Conference (2017, January 24)

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See detailDistinction between urine crystals by automated urine analyzer SediMAX conTRUST is specific but lacks of sensitivity.
Castiglione, Vincent ULiege; CAVALIER, Etienne ULiege; Diop, Coumba Souley ULiege et al

in Clinical Chemistry and Laboratory Medicine (2017)

Urine crystals are commonly encountered but few papers have been published about it while it is useful for patient’s follow-up, particularly the stone-formers. For the first time to our knowledge, we have ... [more ▼]

Urine crystals are commonly encountered but few papers have been published about it while it is useful for patient’s follow-up, particularly the stone-formers. For the first time to our knowledge, we have assessed the performance of an automated urine analyzer to identify and distinguish several types of crystals in a very large cohort of samples. We share in this report the results of method comparison of the SediMAX conTRUST with the polarized light microscopy which is the gold standard. We showed that the distinction between crystals and other urine elements was accurate. Negative predictive value was very good, but the positive predictive value was poor for most of crystals. The discrimination of different types of crystals between them by the automated urine analyzer still requires improvement to decrease reviewing rate and help clinician. [less ▲]

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See detailCase report autour de cristalluries médicamenteuses atypiques
Castiglione, Vincent ULiege; GADISSEUR, Romy ULiege

Conference (2016, October 14)

We report here the cases of uncommon-shaped crystals in patient's urine. The first one is a 73years-old man with massive crystalluria observed in his microscopic urinalysis on Sedimax° (Menarini ... [more ▼]

We report here the cases of uncommon-shaped crystals in patient's urine. The first one is a 73years-old man with massive crystalluria observed in his microscopic urinalysis on Sedimax° (Menarini). Observed crystals had various shape (needle, stick, Feather...). The patient was hospitalized because of lactic acidosis due to suicide attempt by medication overdose. The following medication had been taken: prazepam, acetaminophen, tramadol and Triumeq°, a new anti-retroviral association of dolutegravir, abacavir and lamivudine. Infrared analysis of dryed urine didn"t allow to identify any common stone component, nor any medication. We further discuss about the possible implication of dolutegravir in crystalluria in this patient. Secondly, we show several N-acetylsulfamethoxazol (sulfamethoxazol metabolite) urine crystals detected in microscopic urinalysis of various patients. All had uncommon shape and were sometimes associated to acute kidney injury [less ▲]

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