A 54 year old male with acute lymphocytic leukemia develops a blast crisis. He is treated with intensive systemic chemotherapy. Following treatment, the patient will be at increased risk for the development of:
Correct Answer: Uric acid kidney stones
Description: Uric acid kidney stones in patients with leukemia are secondary to increased production of uric acid from purine breakdown during periods of active cell proliferation, especially following treatment. Vigorous hydration and diuresis are generally instituted after the diagnosis of acute leukemia is made. Uric acid kidney stones are also associated with inborn errors of purine metabolism, such as gout. Pigment gallstones are associated with hemolytic disease. The incidence of this type of gallstone is not increased in treated leukemias. Cholesterol gallstones are associated with diabetes mellitus, obesity, pregnancy, bih control pills, and celiac disease. Cystine kidney stones are rare; they are found in cystinuria. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 16. Pathology of the Kidney and Bladder. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.
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