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Teriflunomide‐associated Urolithiasis: a New Adverse Reaction Explained by Its Uricosuric Effect by Bérenger Largeau; Frédéric Béra; Jacques Vannier; Annie‐Pierre Jonville‐Béra is a Medicine article available to read on EtoBox.

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## Abstract In clinical trials, few investigations have been conducted to determine the mechanism involved in teriflunomide‐associated kidney stone formation. We report the first case of recurrent teriflunomide‐induced uric acid urolithiasis. A 55‐year‐old man with relapsing‐remitting multiple sclerosis experienced three occurrences of urolithiasis several months after the initiation of teriflunomide. While serum uric acid remained stable at 280 mmol/L, 24‐h urine uric acid was increased to 2195 mmol/24 h. For the third episode, computed tomography showed three bladder stones and one stone in the right calyceal group. Endovesical lithotripsy was used to extract four orange‐colored stones of more than 20 mm. Stone analysis exhibited morphology subtype IIIb with 100% of anhydrous uric acid. Given the disease control, teriflunomide was continued. After urinary alkalinization by potassium citrate, the patient remained asymptomatic at 18 months follow‐up. An inhibitory effect of dihydroorotate and/or teriflunomide on urate tubular reabsorption could explain teriflunomide‐associated uric acid urolithiasis. This case in a patient without risk factors suggests that multiple sclerosis patie

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Author

Bérenger Largeau; Frédéric Béra; Jacques Vannier; Annie‐Pierre Jonville‐Béra

Publisher

Wiley

Published

2021

Language

EN

Field

Medicine (Health Sciences)