Nephrocalcinosis seen in all except: March 2005
Ans. B: Acute pancreatitis Primary hyperparathyroidism is single most common cause of nephrocalcinosis in adults Distal Renal Tubular Acidosis is second most common cause of medullary nephrocalcinosis - Both familial and secondary forms have high incidence - Contributing mechanisms are hypercalcemia, acidosis, and reduced excretion of citrate in the presence of increased urinary pH - Renal function is fairly well maintained Other causes of nephrocalcinosis are - Hypervitaminosis D due to treatment of hypoparathyroidism or self-administration of vitamins - Milk-alkali syndrome due to ingestion of milk or alkali for ulcer dyspepsia Sarcoidosis due to increased conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol within the sarcoid granuloma - In children with hypophosphatemic rickets, nephrocalcinosis is increasingly being recognized as most common complication - Idiopathic hypercalciuria, one of the common metabolic diseases, also is known cause of nephrocalcinosis - Medullary sponge kidney is a common cause of medullary calcification in which calcium lies in ectatic collecting ducts rather than renal substance - Renal papillary necrosis associated with phenacetin-induced analgesic nephropathy is identified as calcified papillae rather than speckled pattern. - Rapidly progressive osteoporosis due to immobilization, menopause, senility, or steroids also may cause nephrocalcinosis - Hyperoxaluria, primary (familial) or secondary to increased intake of oxalates, enhanced absorption due to intestinal disease, or ingestion of ethylene glycol or methoxyflurane can induce medullary calcification
Sarcoidosis
Acute pancreatitis
Hyperparathyroidism
Vitamin D intoxication