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The patient was an 8-year-old boy with flank pain and past medical history of more than 10 episodes of renal stone since the age of 18 months. Urine analysis revealed positive blood (20–25/HPF) and hexagonal crystals in the sediment (figure 1). The crystals had a negative birefringence with polarised microscopy. The cyanide nitroprusside test was positive (figure 2). The patient was under the treatment of potassium citrate, high fluid intake, low sodium, and low protein diet since the age of 18 months with the diagnosis of cystinuria. D-penicillamine …
Contributors ZN: Involved in urinalysis interpretation and drafting of the manuscript. MS: Involved in urinalysis interpretation, image preparation and drafting of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Consent obtained from parent(s)/guardian(s).
Provenance and peer review Not commissioned; externally peer reviewed.
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