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Puiguriguer J, Costa-Bauza A, Herrero J, Gomila I, Grases F, Elorza MA, Barceló B. Calcium oxalate monohydrate crystalluria in ethylene glycol poisoning confirmed by scanning electron microscopy. Clin Chim Acta 2022; 531:1-3. [DOI: 10.1016/j.cca.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 11/27/2022]
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Barceló B, Rodriguez A, Ocon Lopez M, Costa-Bauza A, Gomila I, Badal Cogul MB, Grases F. Orbitrap™ high-resolution mass spectrometry for the identification of amoxicillin crystalluria. Clin Chem Lab Med 2018; 56:268-271. [PMID: 29729145 DOI: 10.1515/cclm-2018-0163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/04/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Bernardino Barceló
- Clinical Toxicology Unit, Clinical Analysis Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Palma de Mallorca, Spain, Phone: +87120627, Fax: +871909706
| | - Adrian Rodriguez
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Palma de Mallorca, Spain
| | - Marta Ocon Lopez
- Department of Intensive Care Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Palma de Mallorca, Spain
| | - Isabel Gomila
- Clinical Analysis Department, Hospital Universitari Son Llàtzer, Research Institute of Health Sciences (IdISBa), Palma de Mallorca, Spain
| | | | - Félix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Palma de Mallorca, Spain
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Berga F, Luna P, Martorell C, Rey J, Gomila I, Gimenez S, Costa-Bauza A, Elorza MÁ, Sánchez I, Grases F, Barceló B. 2,4-Diamino-N10-methylpteroic acid (DAMPA) crystalluria in a patient with osteosarcoma treated with carboxypeptidase-G2 rescue after high-dose methotrexate-induced nephrotoxicity. Clin Chim Acta 2018; 487:1-5. [PMID: 30205081 DOI: 10.1016/j.cca.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND High-dose methotrexate (HDMTX) therapy is a key component of many chemotherapy protocols. However, some patients develop HDMTX-induced nephrotoxicity. Carboxypeptidase-G2 (CPDG2) hydrolyses MTX into 2,4-diamino-N10-methylpteroic acid (DAMPA) and glutamic acid, and is used as a rescue agent in patients with nephrotoxicity and delayed elimination. Despite the frequency of HDMTX-induced renal injury, crystalluria is uncommon. Furthermore, crystals are rarely identified by conventional chemical methods. OBJECTIVE To determine the composition of crystalluria in a patient with osteosarcoma who was treated with CPDG2. METHODS Crystalluria was evaluated by optical microscopy, and chemical identification was performed by Fourier-transform infrared (FT-IR) spectroscopy, scanning electron microscopy (SEM) and Orbitrap™ high-resolution mass spectrometry (HRMS). RESULTS The HRMS spectra of the patient's urine sediment showed a main peak at m/z 326.13, corresponding to the molecular mass of DAMPA [(C15H15O2N7) + H+]. The FT-IR spectral patterns of the sediment and DAMPA were not identical. SEM was unable to identify the crystal. CONCLUSION DAMPA crystalluria was identified by Orbitrap™ HRMS in a patient treated with CPDG2 after HDMTX nephrotoxicity. This case reinforces the need to implement adequate measures to prevent nephrotoxicity. In cases of HDMTX-induced nephrotoxicity, urine sediment analysis should be requested.
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Affiliation(s)
- Francisco Berga
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Ctra. de Valldemossa, km 7.5, 07122 Palma de Mallorca, Spain.
| | - Pablo Luna
- Oncology Department, Hospital Universitari Son Espases, Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
| | - Clara Martorell
- Pharmacy Department, Hospital Universitari Son Espases, Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
| | - Juan Rey
- Nephrology Department, Hospital Universitari Son Espases, Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
| | - Isabel Gomila
- Clinical Analysis Department, Hospital Universitari Son Llàtzer, Research Institute of Health Sciences (IdISBa), Ctra. de Manacor, 07198 Palma de Mallorca, Spain.
| | - Sandra Gimenez
- Oncology Department, Hospital Universitari Son Espases, Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
| | - Antonia Costa-Bauza
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Ctra. de Valldemossa, km 7.5, 07122 Palma de Mallorca, Spain.
| | - Miguel Ángel Elorza
- Clinical Analysis Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
| | - Iolanda Sánchez
- Reference Laboratory, Carrer Pablo Iglesias, 57-59, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Félix Grases
- Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Ctra. de Valldemossa, km 7.5, 07122 Palma de Mallorca, Spain.
| | - Bernardino Barceló
- Clinical Analysis Department, Hospital Universitari Son Espases, Research Institute of Health Sciences (IdISBa), Ctra. de Valldemossa, 79, 07120 Palma de Mallorca, Spain.
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