2,8-ジヒドロキシアデニン結晶による間質性腎炎

INTERSTITIAL NEPHRITIS DUE TO CRYSTALS OF 2, 8-DIHYDROXYADENINE

　63歳，男性。右尿管結石による急性腎不全を呈した。以前に左腎結石で左腎摘出術を施行されている。腎瘻造設にもかかわらず慢性腎不全が継続したため，右尿管切石術および腎生検を施行した。摘出結石は2,8-ジヒドロキシアデニン結石で，患者はadeninephos-Phoribosyl transferase完全欠損症であった。腎生検所見は，多数の結晶を伴う間質性腎炎であった。

A 63-year-old man presented with anuria and right lumbar pain. He had undergone left nephrectomy because of left renal stone. Laboratory and X-ray examinations revealed acute renal failure due to a ureteral stone. Although the patient underwent percutaneous nephrostomy, chronic renal failure persisted. A ureterolithotomy and renal biopsy were performed. The removed stone consisted of 2, 8-dihydroxyade-nine. The adenine-phosphoribosyl transferase was completely absent in the blood. The biopsy showed interstitial nephritis with many crystals. Postoperatively, the patient has been given alloprinol and low-purine diet.