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Acute Kidney Injury and Anemia in Infants with Primary Hyperoxaluria: Two Case Reports

Mohammad Amin Fallahzadeh, Elham Vahhab, Babak Shirazi Yeganeh, Mohammad Hossein Fallahzadeh




Primary hyperoxaluria is a rare hereditary disease that usually presents with renal stone, nephrocalcinosis and renal insufficiency. Anemia is usually expected secondary to chronic kidney disease or bone marrow oxalosis following hyperoxalemia. However, sudden onset of renal insufficiency and anemia is very unusual and not easily explained. In this report, we present two infants with histopathologic diagnosis of hyperoxaluria who presented with sudden onset of anuria and severe anemia that required blood transfusion. Both patients had normal body growth indices. Kidneys and urinary bladder x-rays in both infants and serial ultrasound evaluations in one of them did not reveal any renal stone or nephrocalcinosis. The other patient had multiple microcalculi in both kidneys on ultrasound. We may conclude that in any infant with unexplained acute kidney injury and anemia, hyperoxaluria must be considered and kidney biopsy can be conclusive.

Keywords: Primary hyperoxaluria; Anemia; Infant; Acute kidney injury; Renal insufficiency.


Primary hyperoxaluria; Anemia; Infant; Acute kidney injury; Renal insufficiency.


Hoppe B, Beck BB, Milliner DS. The primary hyperoxalurias. Kidney international. 2009;75(12):1264-71.

Cochat P, Rumsby G. Primary hyperoxaluria. The New England journal of medicine. 2013;369(7):649-58.

Bhasin B, Ürekli HM, Atta MG. Primary and secondary hyperoxaluria: Understanding the enigma. World Journal of Nephrology. 2015;4(2):235-44.

Mykytiv V, Campoy Garcia F. Anemia in patient with primary hyperoxaluria and bone marrow involvement by oxalate crystals. Hematology/oncology and stem cell therapy. 2018;11(2):118-21.

Babitt JL, Lin HY. Mechanisms of Anemia in CKD. Journal of the American Society of Nephrology: JASN. 2012;23(10):1631-4.

Saadat M, Ansari-Lari M, Farhud DD. Short Report Consanguineous marriage in Iran. Annals of Human Biology. 2004;31(2):263-9.

Lieske JC, Monico CG, Holmes WS, Bergstralh EJ, Slezak JM, Rohlinger AL, et al. International registry for primary hyperoxaluria. American journal of nephrology. 2005;25(3):290-6.

Jairajpuri ZS, Kishore U, Amitabh V, Agrawal U. Primary infantile hyperoxaluria: a rare cause of acute renal failure. Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2013;24(5):1015-8.

Cochat P, Basmaison O. Current approaches to the management of primary hyperoxaluria. Archives of Disease in Childhood. 2000;82(6):470.

Bakshi NA, Al-Zahrani H. Bone marrow oxalosis. Blood. 2012;120(1):8.

Hung SC, Kuo KL, Peng CH, Wu CH, Wang YC, Tarng DC. Association of Fluid Retention with Anemia and Clinical Outcomes Among Patients With Chronic Kidney Disease. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. 2015;4(1):e001480.

Cochat P, Hulton S-A, Acquaviva C, Danpure CJ, Daudon M, De Marchi M, et al. Primary hyperoxaluria Type 1: indications for screening and guidance for diagnosis and treatment. Nephrology Dialysis Transplantation. 2012;27(5):1729-36.

Tantbirojn P, Kittikowit W, Kingwattanakul P. Primary hyperoxaluria. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 2007;90(8):1669-72.

shitani MB, Monico CG, Milliner DS. Primary hyperoxaluria: new directions for diagnosis and treatment. Pediatrics and Child Health. 2008;18:S54-S6.

Hoppe B. An update on primary hyperoxaluria. Nature reviews Nephrology. 2012;8(8):467-75.

DOI: https://doi.org/10.22037/jpn.v7i2.25769


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