Up to 76% of pediatric patients with the diagnosis of kidney stone disease present metabolic abnormalities, most often hypercalciuria [2]. About 90–95% of kidney stones in children consist of calcium [3]. A specific condition related to high risk of urinary stones formation is a long-term immobilization due to severe neurological disorders. Significant long-term consequences of nephrolithiasis include recurrent stone formation, urinary tract infections, progression of chronic renal dysfunction and finally the rupture of the urinary tract,

most commonly ureters, with urine or blood leakage [4]. We report a case of a quadriplegic patient due to neurofibromatosis type 1 complications (brainstem tumor) with the kidney calyceal rupture in the course of nephrolithiasis, successfully treated with invasive procedures. Retrospective analysis of medical records BMS-354825 clinical trial in a 17-year-old patient, including results of laboratory test, sonography, abdominal X-ray and computed tomography imaging was performed. We present the medical history of a 17-year-old cachectic boy without logical verbal contact, with quadriplegia, epilepsy, and acquired hydrocephalus developed from

the age of 13 as the complication of brain stem tumor in the course of neurofibromatosis type 1. He was admitted to the Pediatric Nephrology Department in severe general condition with the symptoms of sepsis, severe prerenal insufficiency and pneumonia. On laboratory examination, WBC was 30 × 109 l−1, C-reactive protein (CRP) level – 336.0 mg/l Baf-A1 solubility dmso [normal range 0.0–5.0 mg/l], serum creatinine concentration – 353 μmol/l (which Protein Tyrosine Kinase inhibitor corresponded to eGFR value calculated according to Schwartz formula of 17.0 ml/min), serum urea level – 19.4 mmol/l, serum uric acid level – 540 μmol/l, and serum total proteins – 55 g/l. In the abdominal ultrasound stone casts in both kidney pelvises were found. Intravenous antibiotics and conservative symptomatic treatment were applied to achieve

the improvement in patient’s condition (blood test performed on 7th day: WBC – 23 × 109 l−1, CRP – 43.8 mg/l, serum creatinine – 111 μmol/l, and serum urea – 9.5 μmol/l). At the 15th day of hospitalization patient presented anxiety, seemed to feel pain and significant discomfort in the abdomen. The ultrasound examination was comparable to the previous one. The abdomen X-ray revealed large amount of constipated stool in the bowel that confirmed the presence of stone casts in both kidneys, as well as showed the separated stone localized in the right kidney pelvic–ureteral junction and some small concrements at the projection of urinary bladder. There was no significant dilatation of pelvis and calyces (Fig. 1). Constipated stool was removed manually and then enema and laxatives simultaneously with analgesics and spasmolytics were given, leading to improvement of the symptoms. At the 28th day of the hospitalization the episode of gross hematuria was observed.