Article Figures & Data
Figures
- FIGURE 1.
An 83-y-old man with severe sulfa allergy, benign prostatic hyperplasia, left hydronephrosis, and recurrent urinary tract infections. Prediuretic imaging (not shown) demonstrated prominent tracer activity in left pyelocaliceal structures suggestive of obstruction. Postdiuretic imaging with ethacrynic acid in upright position showed prolonged left renal half-time of 29 min with persistent hydronephrosis consistent with urodynamically significant obstruction. Findings for right kidney were normal.
- FIGURE 2.
Sulfonamide drugs share common sulfur moiety (SO2NHR) attached to benzene ring. Sulfonamide antibiotics (upper boxes) have arylamine at N4 position, which incites metabolites responsible for allergic reactions. The diuretics bumetanide, furosemide, and torsemide have molecularly similar N4 sites that can cross-react and harm an allergic patient. Ethacrynic acid (lower box) does not contain a sulfonamide group.
- FIGURE 3.
A 25-y-old man with severe sulfa allergy and history of urinary bladder extrophy—after closure, ureteral reimplantation, and subsequent appendicovesicostomy—presenting with left hydronephrosis and recurrent urinary tract infections. Prediuretic renal scintigraphy (not shown) demonstrated prominent activity in left collecting system suggestive of obstruction. Diuretic challenge using ethacrynic acid showed satisfactory emptying of both collecting systems, with half-times of 3.8 and 4.7 min on right and left sides, respectively, ruling out obstructive uropathy.
