Question

A young patient presented with recurrent colicky abdominal pain, urine microscopy found to have crystals and RBC. What is the diagnosis?

• A. Oxalate stone
• B. PKD
• C. Cystine stones
• D. Glomerulonephritis

Hint:

Cystine stones are typically diagnosed in younger patients with recurrent kidney pain and characteristic crystals on urine microscopy.

Answer 1

The Correct Option is C

The young patient is presenting with recurrent colicky abdominal pain and urine microscopy showing crystals and RBCs. These symptoms can help us deduce the most likely diagnosis by considering the characteristics associated with each option provided:

1. Oxalate stone: Typically related to calcium oxalate crystals in the urine and not specifically associated with RBC presence in each case.
2. PKD (Polycystic Kidney Disease): Characterized by multiple cysts in the kidneys, leading to hypertension, hematuria, and abdominal pain, but usually no crystals.
3. Cystine stones: Cystinuria is a genetic disorder that leads to the formation of cystine stones, characterized by the presence of hexagonal cystine crystals in urine and sometimes hematuria.
4. Glomerulonephritis: Characterized by hematuria and RBC casts, but not typically associated with urinary crystals.

Given the presence of crystals and RBCs, and considering the colicky abdominal pain which is indicative of stone formation, Cystine stones is the most likely diagnosis. Cystinuria, leading to the formation of cystine stones, frequently presents with recurrent episodes of abdominal pain due to stone passage along with distinctive urine microscopy findings of cystine crystals. Therefore, the correct diagnosis is cystine stones.