A bladder stone of 100% calcium tartrate tetrahydrate composition was identified in a man in his early 60s, a finding reported predominantly in animal models and only rarely in humans, with likely contributing factors including excessive consumption of L-carnitine L-tartrate-containing energy drinks and supplements, occupational pesticide exposure, and neurogenic bladder.
Key Findings
Background
Bladder stones account for only 5% of urinary tract stones, and calcium tartrate tetrahydrate (CTT) stones are exceedingly rare in humans.
CTT stone composition has been reported predominantly in animal models.
CTT stones have been reported only rarely in humans.
The rarity of CTT stones poses diagnostic and therapeutic challenges.
Results
A man in his early 60s developed a bladder stone measuring 24.1 mm × 35.6 mm with 100% calcium tartrate tetrahydrate composition.
The patient had untreated diabetes, hypertension, and chronic pesticide exposure.
Stone analysis revealed 100% CTT composition.
The stone dimensions were 24.1 mm × 35.6 mm.
The patient also had neurogenic bladder.
Discussion
The patient's excessive consumption of energy drinks and supplements containing L-carnitine L-tartrate was identified as a likely contributing factor to CTT stone formation.
L-carnitine L-tartrate was present in the energy drinks and supplements consumed by the patient.
Dietary tartrate from supplement use was identified as a potential environmental and metabolic risk factor.
The combination of dietary tartrate intake, occupational pesticide exposure, and neurogenic bladder likely contributed to stone formation.
Discussion
Occupational pesticide exposure was identified as a potential contributing factor to CTT bladder stone formation.
The patient had a history of chronic pesticide exposure.
Chemical exposure was highlighted as a potential environmental risk factor for CTT stones.
Further investigation is needed to clarify how occupational exposures may contribute to rare bladder stone pathogenesis.
Conclusions
Recognition of dietary tartrate, supplement use, and chemical exposure as risk factors for CTT stones is identified as crucial for understanding their pathogenesis.
These factors pose diagnostic and therapeutic challenges.
Further investigation is needed to clarify how dietary tartrate and occupational exposures may contribute to rare bladder stone pathogenesis.
The case highlights potential environmental and metabolic risk factors for CTT stones.