[Type IVa2 urinary lithiasis and associated pathologies: About 3 cases]

Abstract

Introduction: Urinary lithiasis is a very common condition. The morpho-constitutional analysis of urinary stones is important for etiological diagnosis. It guides the explorations and the specific management. Type IV_a2 stones are rare, have particular morphology and correspond to very targeted pathologies. We propose to report our cases of patients diagnosed with type IV_a2 urinary lithiasis.

Methods: Our retrospective work focused on three cases of patients with the morphological type of renal lithiasis IV_a2, collected between 2008 and 2020 in the Medicine A Department of Charles Nicolle Hospital in Tunis.

Results: All three patients were female; average age 37.6 years. The clinical symptomatology was identical marked by renal colic with recurrent episodes. The presence of a type IV_a2 stone, isolated or associated with other components, guided the etiological investigation to look for a secondary or primary cause of distal renal tubular acidosis. We retained the diagnosis of a primary hyperparathyroidism in one case and a primary Gougerot-Sjögren's syndrome in the second case, and probable in the last case.

Conclusion: Determination of urolithiasis nature (morphological and chemical), although carried out late, was of major interest to us and allowed us to make the diagnosis of distal tubular acidosis.

Keywords: Acidose tubulaire distale carbapatite; Analyse morpho-constitutionnelle; Carbapatite; Distal tubular acidosis; Morpho-constitutional analysis; Urolithiases; Urolithiasis.