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Cardiac Lesions in Secondary Oxalosis

Cardiac Lesions in Secondary Oxalosis Abstract The significance of calcium oxalate deposition in the myocardium was studied at autopsy in 21 patients with renal insufficiency. The oxalate crystals in the myocardium frequently were associated with focal necrosis and marked fibrosis. Of seven patients with severe oxalate deposits, six had extensive myocardial fibrosis. Four of these six had severe, intractable congestive heart failure. One had complete heart block and Stokes-Adams attacks, and at autopsy oxalate crystals were observed in the cardiac conducting system. These observations suggest that myocardial oxalosis is another potential complication of renal insufficiency and that oxalate-induced myocardial abnormalities may contribute to congestive heart failure and conduction abnormalities in patients with uremia. References 1. Salyer WR, Keren D: Oxalosis as a complication of chronic renal failure. Kidney Int 4:61-66, 1973.Crossref 2. Johnson FB, Pani K: Histochemical identification of calcium oxalate. Arch Pathol 74:347-351, 1962. 3. Hudson REB: Surgical pathology of the conducting system of the heart. Br Heart J 29:646-670, 1967.Crossref 4. Bennett B, Rosenblum C: Identification of calcium oxalate crystals in myocardium in patients with uremia. Lab Invest 10:947-955, 1961. 5. Walls J, Morley AR, Kerr DNS: Primary hyperoxaluria in adult siblings: With some observations on the role of regular hemodialysis therapy. Br J Urol 41:546-553, 1969.Crossref 6. Slama R, Josso F, Antoine B: Manifestations myocardiques de l'oxalose. Arch Mal Coeur 53:917-929, 1960. 7. Edwards DL: Idiopathic familial oxalosis. Arch Pathol 64:546-555, 1957. 8. Stauffer M: Oxalosis: Report of a case with a review of the literature and discussion of the pathogenesis. N Engl J Med 263:386-390, 1960.Crossref 9. Deodhar SD, Tung KSK, Nakamoto S: Renal homotransplantation in a patient with primary familial oxalosis. Arch Pathol 87:118-124, 1969. 10. Enger E, Serck-Hanssen A, Rokkones T: Oxalosis: A case report. Acta Med Scand 177:409-414, 1965. 11. Coltart DJ, Hudson REB: Primary oxalosis of the heart: A cause of heart block. Br Heart J 33:315-320, 1971.Crossref 12. Terman DS, et al: Cardiac calcification in uremia: A clinical, biochemical, and pathologic study. Amer J Med 50:744-755, 1971.Crossref 13. Zarembski PM, Hodgkinson A, Parsons FM: Elevation of the concentration of plasma oxalic acid in renal failure. Nature 212:511-512, 1966.Crossref 14. Williams HE, Smith LH: Disorders of oxalate metabolism. Am J Med 45:715-735, 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cardiac Lesions in Secondary Oxalosis

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1974.00320200060006
Publisher site
See Article on Publisher Site

Abstract

Abstract The significance of calcium oxalate deposition in the myocardium was studied at autopsy in 21 patients with renal insufficiency. The oxalate crystals in the myocardium frequently were associated with focal necrosis and marked fibrosis. Of seven patients with severe oxalate deposits, six had extensive myocardial fibrosis. Four of these six had severe, intractable congestive heart failure. One had complete heart block and Stokes-Adams attacks, and at autopsy oxalate crystals were observed in the cardiac conducting system. These observations suggest that myocardial oxalosis is another potential complication of renal insufficiency and that oxalate-induced myocardial abnormalities may contribute to congestive heart failure and conduction abnormalities in patients with uremia. References 1. Salyer WR, Keren D: Oxalosis as a complication of chronic renal failure. Kidney Int 4:61-66, 1973.Crossref 2. Johnson FB, Pani K: Histochemical identification of calcium oxalate. Arch Pathol 74:347-351, 1962. 3. Hudson REB: Surgical pathology of the conducting system of the heart. Br Heart J 29:646-670, 1967.Crossref 4. Bennett B, Rosenblum C: Identification of calcium oxalate crystals in myocardium in patients with uremia. Lab Invest 10:947-955, 1961. 5. Walls J, Morley AR, Kerr DNS: Primary hyperoxaluria in adult siblings: With some observations on the role of regular hemodialysis therapy. Br J Urol 41:546-553, 1969.Crossref 6. Slama R, Josso F, Antoine B: Manifestations myocardiques de l'oxalose. Arch Mal Coeur 53:917-929, 1960. 7. Edwards DL: Idiopathic familial oxalosis. Arch Pathol 64:546-555, 1957. 8. Stauffer M: Oxalosis: Report of a case with a review of the literature and discussion of the pathogenesis. N Engl J Med 263:386-390, 1960.Crossref 9. Deodhar SD, Tung KSK, Nakamoto S: Renal homotransplantation in a patient with primary familial oxalosis. Arch Pathol 87:118-124, 1969. 10. Enger E, Serck-Hanssen A, Rokkones T: Oxalosis: A case report. Acta Med Scand 177:409-414, 1965. 11. Coltart DJ, Hudson REB: Primary oxalosis of the heart: A cause of heart block. Br Heart J 33:315-320, 1971.Crossref 12. Terman DS, et al: Cardiac calcification in uremia: A clinical, biochemical, and pathologic study. Amer J Med 50:744-755, 1971.Crossref 13. Zarembski PM, Hodgkinson A, Parsons FM: Elevation of the concentration of plasma oxalic acid in renal failure. Nature 212:511-512, 1966.Crossref 14. Williams HE, Smith LH: Disorders of oxalate metabolism. Am J Med 45:715-735, 1968.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1974

References