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A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate

Akram Askar.

Abstract
Introduction: This case reports the relationship between treatment with topiramate and propensity for Metabolic Acidosis and stone formation in the kidneys in a pediatric patient.
Case Presentation: The patient is a 14 years old girl known to have Cerebral Palsy and Hydrocephalus for which she was treated with Ventriculoperitoneal shunt; along with congenital brain atrophy and epilepsy, presented with vomiting, anorexia, right loin pain. She had a past medical history of several anti-epileptic drugs including Phenobarbitone, Phenytoin, Carbamazepine, Levetiracetam. She was started on Topiramate for past 8 years. She looked unwell and hypovolemic but on examination was afebrile with stable vital signs. There was, however, tenderness at right loin and suprapubic area. Midstream Urine analysis showed urinary tract infection with many pus cells. Labs showed Leukocytosis, along with High Anion Gap Metabolic Acidosis. The final diagnosis was made for metabolic acidosis and nephrolithiasis precipitating urinary tract infection.
Conclusion: Topiramate has been reported to cause metabolic acidosis and nephrolithiasis which is more pronounced in pediatric patients than adult patients. Evidence-based on literature indicates a higher risk in children: 30-50% of adults and 70% of children using topiramate develop metabolic acidosis, while 1.5% of adults and 5% of children develop kidney stones.

Key words: Renal Calculi, Topiramate, Acidosis


 
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Pubmed Style

Akram Askar. A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. Ulutas Med J. 2018; 4(3): 159-163. doi:10.5455/umj.20180201110350


Web Style

Akram Askar. A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. http://www.ulutasmedicaljournal.com/?mno=289977 [Access: October 17, 2018]. doi:10.5455/umj.20180201110350


AMA (American Medical Association) Style

Akram Askar. A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. Ulutas Med J. 2018; 4(3): 159-163. doi:10.5455/umj.20180201110350



Vancouver/ICMJE Style

Akram Askar. A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. Ulutas Med J. (2018), [cited October 17, 2018]; 4(3): 159-163. doi:10.5455/umj.20180201110350



Harvard Style

Akram Askar (2018) A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. Ulutas Med J, 4 (3), 159-163. doi:10.5455/umj.20180201110350



Turabian Style

Akram Askar. 2018. A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. THE ULUTAS MEDICAL JOURNAL, 4 (3), 159-163. doi:10.5455/umj.20180201110350



Chicago Style

Akram Askar. "A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate." THE ULUTAS MEDICAL JOURNAL 4 (2018), 159-163. doi:10.5455/umj.20180201110350



MLA (The Modern Language Association) Style

Akram Askar. "A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate." THE ULUTAS MEDICAL JOURNAL 4.3 (2018), 159-163. Print. doi:10.5455/umj.20180201110350



APA (American Psychological Association) Style

Akram Askar (2018) A Case of Nephrolithiasis and Metabolic Acidosis induced by Topiramate. THE ULUTAS MEDICAL JOURNAL, 4 (3), 159-163. doi:10.5455/umj.20180201110350








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