Ureteral stones due to systemic mastocytosis: diagnostic and therapeutic characteristics

Molderings, Gerhard J.; Solleder, Gerold; Kolck, Ulrich W.; Homann, Jürgen; Schröder, D; Kügelgen, Ivar von; Vorreuther, R.

doi:10.1007/s00240-009-0198-0

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…A role for mast cells in the pathogenesis of urinary stone disease has not been well described to date. However, a recent report of patients with systemic mastocytosis suggested that enhanced stone formation may be observed in this patient population (33). Thus, future studies may yet reveal an association between inflammation, mast cells, and stone risk.…”

Section: Discussionmentioning

confidence: 88%

Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease

Dejban

Wilson

Jayachandran

et al. 2022

CJASN

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Background and objectives: Urinary stone disease has been associated with inflammation, but the specific cell interactions that mediate events remain poorly defined. This study compared calcification and inflammatory cell patterns in kidney tissue from radical nephrectomy specimens of patients without and with a history of urinary stone disease. Design, setting, participants, and measurements: Non-tumor parenchyma of biobanked radical nephrectomy specimens from age- and sex-matched stone formers (n=44) and non-stone formers (n=82) were compared. Calcification was detected by Yasue staining and inflammatory cell populations by immunohistochemistry for CD68 (pro-inflammatory M1 macrophages), CD163 and CD206 (anti-inflammatory M2 macrophages), CD3 (T-lymphocytes), and tryptase (mast cells). Calcifications and inflammatory cells were quantified in cortex and medulla using Image-Pro® analysis software. Results: Calcification in the medulla of stone formers was higher than in non-stone formers (p<0.001). M1 macrophages in the cortex and medulla of stone formers were greater than in non-stone formers (p<0.001), and greater in stone former medulla than stone former cortex (p=0.02). There were no differences in age, sex, body mass index, tumor characteristics (size, stage, or thrombus), vacular disease status, or estimated glomerular filtration rate between the groups. M2 macrophages, T-lymphocytes, and mast cells did not differ by stone former status. There was a correlation between M1 macrophages and calcification in the medulla of stone formers (rho=0.48; p=0.001) and between M2 macrophages and calcification in the medulla of non-stone formers (rho=0.35; p=0.001). T-lymphocytes were correlated with calcification in the cortex of both non-stone formers (rho=0.27; p=0.01) and stone formers (rho=0.42; p=0.004) whereas mast cells and calcification were correlated only in cortex of stone formers (rho=0.35; p=0.02). Conclusions: Higher medullary calcification stimulated accumulation of pro-inflammatory rather than anti-inflammatory macrophages in stone formers.

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Section: Discussionmentioning

confidence: 88%

Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease

Dejban

Wilson

Jayachandran

et al. 2022

CJASN

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“…Irrespective of these considerations it seems reasonable because of the other clinically proven positive effects of a sufficient vitamin D level (for referen-ces, see [7]) to aim for a sufficient blood level by supplementation if the vitamin D level is too low in a patient. However, in MCAS patients this should be achieved slowly and with low doses of exogenous vitamin D, since application of high vitamin D doses can increase the risk for the development of renal and ureteral calculus [33].…”

Section: Discussionmentioning

confidence: 99%

Lower prevalence of vitamin D insufficiency in German patients with systemic mast cell activation syndrome compared with the general population

Wirz¹,

Hertfelder

Seidel³

et al. 2017

Z Gastroenterol

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The common mastocytosis variant systemic mast cell activation syndrome (MCAS) may underlie at least a subset of patients with irritable bowel syndrome (IBS). A critical role of vitamin D (VD) in the stabilization of mast cells (MCs) with deficiency of VD resulting in MC activation has been demonstrated. If so, supplementation of VD would be a potential therapeutic approach in the treatment of those IBS patients. We investigated in the present study for the first time systematically whether the VD level in 100 MCAS patients differed from that in the German general population (Ggp) and made a first attempt to elucidate potential reasons for possible differences by simultaneously determining the blood levels of heparin and cholesterol. In contrast to the Ggp, the VD level was detected in a sufficient range (> 30 ng/mL) in 53 % of the MCAS patients (Ggp 8 %), and only 34 % had values in the range of deficiency (< 20 ng/mL; GgP 75 %). There was no correlation between VD blood level and heparin and cholesterol blood levels. The demonstration that in the majority of MCAS patients the VD level is not in a deficient range argues against an essential contribution of VD deficiency to the high prevalence of MCAS in Germany. Our findings do not exclude the possibility of smaller effects of VD level on MC activation in vivo. However, if such effects are present, the effect sizes seem to be too small to become identifiable in the multifactorial process of disease development.

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“…Osteoporosis is seen as a very frequent sign of mastocytosis due to which it is also considered as an associated complication of systemic mastocytosis. To treat this, H1 and H2 histamine receptor antagonists are given [26]. A very common symptom of stone formation is pain which can be of two types depending upon the location and movement of the stone.…”

Section: Hrh1 (Histamine Receptor H1)mentioning

confidence: 99%

Insights into association between urolithiasis and prostate cancer

Sun¹,

Kour²,

Wang³

et al. 2021

JOMH

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Background and objective: Urolithiasis or renal stones form a major urinary tract infection with formation of calciﬁcations in the bladder and uterus. With the lifestyle diseases burgeoning, the renal stones have become a common cause with an approximate 1 in 1000 people affected all over the world with a risk ratio of 3 : 1 in men and women. On the other hand, prostate or genitourinary cancers are well documented to be associated with urolithiasis. Methods: A gene list was prepared from the published NCBI dataset, comprising all the genes related to urolithiasis primarily with mutations (both pathogenic and likely pathogenic Single nucleotide polymorphisms, SNP's) for every particular gene screened later from the published datasets. To see the interactions among all the potential genetic factors, PPI based tools were used and an interaction map was prepared. For the characterization of mutations, we have used gnomAD for verifying all the SNPs whether they are synonymous or nonsynonymous mutations. Results: We outlined the list of genes and discussed the systems bioinformatics integrated approach associated with it. Conclusion: We found a large number of genes common to them and their association is subtly known for immunomodulatory response.

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Ureteral stones due to systemic mastocytosis: diagnostic and therapeutic characteristics

Cited by 7 publications

References 16 publications

Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease

Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease

Lower prevalence of vitamin D insufficiency in German patients with systemic mast cell activation syndrome compared with the general population

Insights into association between urolithiasis and prostate cancer

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