Medullary nephrocalcinosis in a pediatric patient: answer

Excerpt

Our patient’s main problem was the presence of medullary nephrocalcinosis (NC). Nephrocalcinosis is defined as calcification located in the renal parenchyma. It can be subdivided into two forms, medullary and cortical [1], with the former usually a bilateral process with symmetric involvement [2, 3]. Medullary NC is the most common form and occurs in various disorders (Table 1) [1, 4‐6]. Based on clinical and laboratory findings, we easily ruled out Cushing’s syndrome, malignancy, sarcoidosis, sickle cell disease, idiopathic hypercalcemia, chronic pyelonephritis, hypervitaminosis D, hyperparathyroidism, hyper/hypothyroidism, and drug-associated NC. Renal tubular acidosis, primary hyperoxaluria, and purine/pyrimidine pathway disorders were also not considered as realistic diagnoses because of normal acid–base parameters and the excretion of amino acids, oxalate, and uric acid. …