Medullary sponge kidney and ulcerative colitis in the same patient: an extremely rare combination

Abstract

SUMMARY
We describe a female patient with ulcerative colitis from
the age of 19, who was diagnosed as having medullary
sponge kidney 3 years after the diagnosis of inflammatory
bowel disease. The diagnosis of medullary sponge kidney
was based on the typical appearance of both kidneys on
abdominal ultrasound examination. All other well-known
causes of medullary sponge kidney were excluded on the
basis of the relevant laboratory investigation. So far, the
patient has experienced no renal colic or urinary infections.
Her renal function is normal. She is under maintenance
treatment with azathioprine. The benign nature of the
situation was explained. She was advised to drink at least
one and a half litres of water daily, in order to reduce the
risk of nephrolithiasis. The combination of the two
disorders in our patient is probably the result of chance.
However, bearing in mind the potentially dangerous longterm
results of medullary sponge kidney, we suggest that
patients with ulcerative colitis must have a careful
ultrasound examination of both kidneys at least at the
beginning of inflammatory bowel disease, as conservative
measures could result in avoidance of potentially dangerous
complications, such as renal stones and infections.