High-altitude polycythemia (HAPC) is a common disease in high-altitude areas characterized by excessive erythrocyte proliferation and severe hypoxemia. Recently, the incidence of ureteral calculi has risen. However, cases of ureteral calculi associated with HAPC have not been reported.
We present the cases of 2 patients (26-year-old female, Case 1; 31-year-old male, Case 2) with HAPC who were born in the lowlands and worked in areas of high altitudes. Both patients were admitted to the hospital with acute severe pain in the ureter as the first symptom.
Urological examinations confirmed the presence of a ureteral stone. Interestingly, the biochemical tests showed elevated serum uric acid levels, and the calculous component analysis suggested anhydrous uric acid.
In the first case, the patient underwent extracorporeal shock wave lithotripsy. In the second case, the patient underwent right ureteroscopy and right ureteral stenting. The patient received postoperative anti-inflammatory, hemostatic, and rehydration therapy.
Both patients recovered well with no recurrences observed upon regular re-examinations.
Recently, extensive research has demonstrated a significant correlation between hyperuricemia and HAPC. Therefore, we speculated that the occurrence of ureteral calculi among immigrants to the plateau might be related to hyperuricemia associated with HAPC. This case report and literature review highlights that the prevention of ureteral calculi in patients with polycythemia who immigrate to the plateaus from high-altitude areas should be considered. Additionally, the serum uric acid levels and urine pH should be monitored regularly.
Medicine. 2021 Feb 19 [Epub]
Min Yang, Sen Cui, Tanna Wuren, Kexiong Ma, Ri-Li Ge, Linhua Ji
Research Center for High Altitude Medicine, Qinghai University., Affiliated Hospital of Qinghai University, Xining., Affiliated Huadu Hospital, Southern Medical University.