Case report
Primary oxalosis

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Abstract

This man with primary oxalosis had a familial history of the disease, onset of symptoms in adult age and elevated levels of serum and urinary oxalic acid, as well as increased urinary excretion of glycolic and glyoxylic acid. Uremia developed and dialysis was tried but the disease progressed, with the appearance of polyneuropathy and peripheral ischemic alterations leading to atrophy and gangrene. He died in uremia after 14 months of hemodialysis. It is suggested that hemodialysis should not be utilized in patients with primary oxalosis.

Postmortem examinations included light microscopy, and transmission and scanning electron microscopy. Calcium oxalate deposits were found in kidneys (glomeruli, interstitium, and tubular epithelial cells and lumens), myocardium, spongy bone, prostate, testes, striated muscles, aorta, inferior vena caval vein and in numerous arteries and arterioles. The oxalate crystals are believed to be primarily formed intracellularly in the various organs. Additional findings were chronic pyelonephritis, degeneration of peripheral nerve fibers and perineural fibrosis.

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    1

    From the Departments of Pathology and Internal Medicine, University of Umeå, Umeå, Sweden.

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