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Teenage Boy with Severe Side Pain


A 14 year old boy went to his doctor complaining of severe side and back pain, which got worse while he slept. His family history showed males on both his mother's side and his father's side with chronic kidney stones. Urinalysis results are:
Color
 yellow
 Protein
 negative
 Blood
 small
Appearance
 cloudy
 Glucose
 negative
 Urobilinogen
 normal
Sp. Gravity
 1.025
 Ketones
 negative
 Nitrite
 negative
pH
 6.0
 Bilirubin
 negative
 Leukocyte
 negative

Microscopic
10-20 RBCs/hpf                                       Few Calcium Oxalate crystals
Many crystals which look like this:
cysteine crystals  





Questions


1. What is the name of the major crystal present?
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2. What medical condition is the most likely cause of the side and back pain?
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3. What amino acids are present in the urine in addition to the visible one?
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4. Sometimes the crystals at the end of the arrow below form 6-sided crystals and get confused with the one above, how can they be differentiated?

arrow points to uric acid, calcium oxalate also present
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5. Why is family history important in this case?
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Colleen Carey | Honors Urinalysis | Fall 2005