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Ann Clin Biochem. 2017 May;54(3):406-411. doi: 10.1177/0004563216677101. Epub 2017 Jan 10.

Late diagnosis of primary hyperoxaluria type III.

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1 Biothérapies des Maladies Génétiques, Inflammatoires et Cancers, Université de Bordeaux, Bordeaux, France.
2 INSERM, Biothérapies des Maladies Génétiques, Inflammatoires et Cancers, Bordeaux, France.
3 Laboratoire de Biochimie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
4 Service de Néphrologie Pédiatrique, Centre de Référence Maladies Rénales Rares du Sud-ouest, Centre Hospitalier Universitaire de Bordeaux, Bordeaux Cedex, France.
5 Département de Pharmacologie Clinique, Centre Hospitalier Universitaire de Bordeaux, France.
6 Service des Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Centre de Biologie et Pathologie Est, CHU de Lyon, Bron, France.
7 Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.


We report the case of a 78-year-old patient with late diagnosis of hyperoxaluria type III (PH3). He developed renal failure after nephrectomy for clear cell papillary renal carcinoma and complained of recurrent urolithiasis for some 30 years, whose aetiology was never identified. Biochemical laboratory investigations of urine and urolithiasis composition revealed marked hyperoxaluria but normal concentrations of urinary glyceric and glycolic acid as well as stones of idiopathic calcium-oxalate appearance. Furthermore, the dietary survey showed excessive consumption of food supplements containing massive amounts of oxalate precursors. However, the persistence of excessive hyperoxaluria after his eating habits was changed leading us to perform molecular genetic testing. We found heterozygous mutations of the recently PH3-associated HOGA1 gene when sequencing PH genes. This is the first description of late diagnosis primary PH3 in a patient with several additional pro-lithogenic factors. This case illustrates the importance of undertaking a complete biological work-up to determine the aetiology of hyperoxaluria. This may reveal underdiagnosed primary hyperoxaluria, even in older patients.


Hyperoxaluria; infrared spectroscopy; kidney stones; lithiasis

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