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Question

RECEIVED PRE EMPLOYMENT XRAYS WHICH STATED PHLEBOLITH IN THE LEFT PELVIS AND CALCIFIC IRREGULAR SHAPED DENSITIES PROJECTING LATERAL TO THE TRANSVERSE PROCESS ON THE RIGHT. I AM A 27 YEAR OLD FEMALE WHO TAKES TOPAMAX FOR EPILEPSY. I KNOW THAT THERE ARE SOME THINGS SUCH AS KIDNEY STONES THAT CAN BE CAUSED BY MY MEDICATION. ARE THESE FINDINGS ANYTHING TO BE WORRIED ABOUT?

Submitted: 30 days and 17 hours ago.
Category: Health
Value: $18
Status: CLOSED
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Optional Information

Gender: Female
Age: 27

Already Tried:
just received these results from employer (hospital)

Posted by Dr Wu 30 days and 16 hours ago.

Answer

Hi,

Thank you for submitting your question.

A phlebolith is a small area of calcium deposits within a vein. These are very common in the veins of the lower part of the pelvis, and they are of no clinical importance.

The calcified irregular shaped denisities in the right kidney most likely represent small kidney stones..

As you mentioned, topamax has been shown to increase kidney stone formation. Topamax appears to inhibit the body's natural ability to excrete calcium. As a result, calcium accumulates in the kidneys and form stones.

It sounds like you do not have any symptoms at this point. I would urge that you talk to your doctor about using a different medication for epilepsy. If the stones become larger, they can cause painful symptoms as well as affect your kidney function. Your doctor may also want to do a blood test to check your blood calcium level.

Meanwhile you should keep yourself well-hydrated by drinking plenty of fluids.

Studies have shown that drinking lemonade can be helpful in dissolving kidney stones. Lemonade increases the levels of citrate in your urine, and citrate helps prevent stone formation.

 

I hope this answers your question.

30 days and 16 hours ago.

Reply

I am having pain in my lower back (not excruciating) but very uncomfortable and around in my side to my lower rib. I have been on about 15 different seizure medications that did not help. Topamax has been a miracle drug for me. Seizures are less severe and much less often.

 

Is there any other suggestions? Just wanted to know before accepting.

 

Thank you so much for your quick response.

Accepted Answer

Pain from kidney stones tend to come and go, and is usually moderate to severe. Constant back pain is less likely from kidney stones. One way to find out is to run a blood test(looking for elevated white blood cell count) and a urine test.

If these kidney stones are indeed causing pain, in most cases small stones can be passed without any medical intervention(except for pain medications).

In terms of topamax, I can understand your reluctance to discontinue it since it works so well for you. Increasing the amount of fluid you drink may be able to counteract the effect of topamax on the kidneys(topamax causes calcium deposits, but increasing urine flow can flush out the excess calcium). If you do choose to stay on topamax, another abdominal xray/CT should be done in 2-3 months to monitor the size of the stones.

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Expert: Dr Wu
Pos. Feedback: 100.0 %
Accepts: 
Answered: 10/22/2009

Doctor (MD)

Board certified family physician, extensive experience in adult medicine, specalizes in geriatrics.

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