Bilateral ureteral obstruction due to primary myelofibrosis caused hyperuricaemia

• DOI: 10.2298/aci1002079c
• Publication Date: 2010-09-15T11:58:45Z
• Authors: Z.P. Cvetkovic; B.R. Cvetkovic; D. Celeketic; D. Milenkovic; G. Perunicic-Pekovic
• Keywords: Anuria

In healthy population, uric acid comprises the major component of 10-20% renal stones. Extreme hiperuricaemia is seen in cancer patients with tumor lysis syndrome (TLS) which classically associated haematological malignancies rapid growth rates such as acute lymphoid leukaemia and high grade lymphomas. Primary melofibrosis (Agnogenic myeloid metaplasia- AMM) a chronic myeloproliferative disease characterized by splenomegaly, leukoerythroblastic blood picture, teardrop poikilocytosis varying degrees marrow fibrosis. Due to increased extramedullary haematopoiesis, hiperuricemia may occur. However, TLS AMM is, according available literature, described just one patient. this paper we present case 47-year-old male patient who was admitted hospital symptoms fatigue small amount urine, clinical signs plethora enlarged spleen. The laboratory findings showed leuko-and erythrocytosis, levels urea-BUN (32 mmol/l) creatinine (766 well (920 mmol/l). immediate abdominal ultrasound confirmed extreme but also bilateral hydronephrosis II-III two stones proximal part right ureter left empty bladder. Stones were not on plain film. Since complete anuria, further elevation BUN levels, ureteral stents applicated together extensive hydration, urine alkalization administration allopurinol resulted recovery kidney function. bone biopsy performed histopathological diagnosis was: Hypercellulary phase AMM.