Amirhesam Alirezaei
1 
, Hamed Ebrahimibagha
2 , Mahmoud Parvin
3, Majid Ali Asgari
4, Leyla Bagheri
5* 1 Department of Nephrology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Medical Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of pathology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Urology and Nephrology Research Center, Shahid Modarress Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Primary hyperoxaluria is a rare congenital autosomal recessive disorder disrupting the glyoxylate metabolism pathway in the liver. Type1 primary hyperoxaluria is caused by a deficiency in a specific liver enzyme namely, alanine glyoxylate-aminotransferase which catalyzes the conversion of glyoxylate to glycine. By the absence of this enzyme, glyoxylate is converted to oxalate and high oxalate level causes deposition of insoluble calcium oxalate crystals in different organs specifically kidneys. The disease usually manifested by recurrent nephrolithiasis and/or nephrocalcinosis leads to renal failure. This report describes an end-stage renal disease case of a 36-year-old Iranian woman without any history of nephrolithiasis who underwent kidney transplantation. She developed an early onset transplant kidney failure. The patient underwent kidney biopsy, which revealed oxalate nephropathy, accordingly the genetic study confirmed diagnosis of primary hyperoxaluria. This rare case shows how type 1 primary hyperoxaluria can develop after kidney transplantation without having any manifestation prior to transplantation
Implication for health policy/practice/research/medical education:
Type 1 primary hyperoxaluria is a situation in which due to specific enzyme deficiency, the Oxalate amount of blood increases and causes recurrent nephrolithiasis and/or nephrocalcinosis which can progress toward renal failure. In this report we describe a case without any history of nephrolithiasis who underwent kidney transplantation and developed transplant kidney failure due to new onset primary hyperoxaluria.
Please cite this paper as: Alirezaei A, Ebrahimibagha H, Parvin M, Ali Asgari M, Bagheri L. Late onset primary hyperoxaluria after kidney transplantation in a 36-year-old woman. J Nephropathol. 2024;13(3):e17130. DOI: 10.34172/jnp.2022.17130.