Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 5-year-old boy had periodic spasms and startle-induced drop attacks. Zonisamide (ZNS) was partially effective for the former seizures, and propranolol for the latter. An add-on therapy with ACTH resulted in a transient disappearance of seizures and an improvement of EEG. However, the patient developed urolithiasis with resultant hematuria and pyelectasis during ACTH therapy. ZNS can induce urolithiasis by increasing urinary pH and calcium (Ca) excretion, and ACTH may facilitate this rare adverse effect of ZNS by further increasing the urinary Ca. Hydrochlorothiazide could resolve the urolithiasis by decreasing the urinary Ca excretion.
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PMID:[Urolithiasis induced by combined ACTH and zonisamide treatment in a patient with startle induced epilepsy]. 1223 54

Purpose. Adjunctive zonisamide therapy was demonstrated to be beneficial for multiple-disabled patients with refractory childhood-onset epilepsy. Zonisamide is well tolerated, but urolithiasis and calcium sludge in the bladder were sometimes described in patients treated with antiepileptic drug polytherapy including zonisamide. In previous studies, alkaline urine and crystalluria were shown to be risk factors for urolithiasis. Therefore, the effects of zonisamide addition and withdrawal on the urinary pH and crystalluria were investigated in patients treated with antiepileptic drug polytherapy to clarify the cause of urolithiasis induced by zonisamide. Methods. The urinary pH and the degree of crystalluria were retrospectively studied in epilepsy patients one month after the addition or withdrawal of zonisamide as part of their antiepileptic drug treatment regimen over the previous three years. Results. A total of 27 zonisamide-on patients and 16 zonisamide-off patients were enrolled in the study. The urinary pH did not change after the addition or withdrawal of zonisamide. However, the degree of crystalluria significantly increased after the addition (P < 0.001) of zonisamide and decreased after its withdrawal (P < 0.01). Conclusions. Zonisamide induces crystalluria without alkalinization of the urine. Crystalluria should be carefully monitored in patients treated with zonisamide to prevent urolithiasis.
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PMID:Zonisamide Induces Crystalluria without Urinary pH Changes in Children and Young Adults. 2417 Nov 22