Morphazinamide

Abstract: 1. The demonstration of an inheritable anomaly of erythrocyte oxalate transport in 'primary' calcium nephrolithiasis suggested that this disease might be a generalized metabolic disorder characterized by a defect in cellular anion transport. 2. To determine whether this anomaly is restricted to oxalate alone, we studied erythrocyte transmembrane urate self-exchange in calcium-oxalate renal stone formers in whom urinary excretion of uric acid is frequently increased. 3. Abnormal urate self-exchange was found in 30% of the patients. The urate self-exchange rate constant was correlated with 24 h urinary excretion of uric acid; the erythrocyte anomaly was also associated with the frequency of hyperuricosuria and a more intense disease activity. Transmembrane urate self-exchange was inhibited by stilbene and heparan sulphate. Morphazinamide administration did not reduce urinary urate excretion in patients with abnormal urate erythrocyte self-exchange. 4. These findings suggest that hyperuricosuria during calcium-oxalate renal stone disease might be due to a cellular defect in urate transport, and further support the hypothesis that idiopathic nephrolithiasis is a metabolic disorder characterized by a defect in cellular anion transport.

Abstract: PURPOSE: To discuss a case of Churg-Strauss syndrome that developed bilateral conjunctival involvement while recovering from miliary tuberculosis. METHODS: Case report and literature review. RESULTS: A 22-year-old man who was on oral prednisolone for Churg-Strauss syndrome since 2002 contracted miliary tuberculosis in June 2004. The diagnosis was confirmed by liver biopsy. Ophthalmologic examination was within reference limits except for bilateral multifocal choroiditis. A combined therapy of rifampicin, ethambutol, streptomycin, and morphazinamide was started on June 24, 2004. Complete recovery was achieved, and the antituberculosis therapy was terminated in June 2005. The patient noted redness and pain in both eyes a month later. He had bilateral irregular, pink-yellow, gravel-like infiltrations involving the bulbar conjunctiva. Biopsy revealed granulomas with central fibrinoid necrosis, histiocytes, and eosinophils, suggestive of conjunctival involvement of Churg-Strauss syndrome. Topical dexamethasone 0.1% drops were started 4 times per day and tapered gradually. Lesions totally regressed within 2 months. No recurrence was noted during a follow-up of 11 months. CONCLUSIONS: Churg-Strauss syndrome may rarely involve the conjunctiva, and conjunctival lesions respond favorably to topical steroids.