Case Report Ureteropelvic Junction Obstruction and Parathyroid Adenoma: Coincidence or Link? Salah Termos, 1 Majd AlKabbani, 1 Tim Ulinski, 2 Sami Sanjad, 3 Henri Kotobi, 2 Francois Chalard, 2 and Bilal Aoun 2,3 1 Hepatobiliary and Transplant Unit, Department of Surgery, Al-Amiri Hospital, Kuwait City, Kuwait 2 Pediatric Nephrology, Armand Trousseau Hospital, APHP, Paris, France 3 Division of Pediatric Nephrology, Department of Pediatrics, American University of Beirut, Beirut, Lebanon Correspondence should be addressed to Salah Termos; salahtermos@gmail.com Received 6 July 2017; Revised 11 September 2017; Accepted 25 September 2017; Published 17 October 2017 Academic Editor: Salih Kavukcu Copyright © 2017 Salah Termos et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of upper urinary tract obstruction in children. It is generally diagnosed in the routine work-up during antenatal period and is characterized by spontaneous recovery. It can be associated with urolithiasis; hence further investigation should be carried out. We report the case of a 15-year-old boy, who is known to have right UPJO, presented with right renal colic and discovered to have bilateral kidney stones. Further studies showed primary hyperparathyroidism and genetic analysis revealed a CDC73 mutation (initially HRPT2). We believe that association of UPJO and PHPT is a rare coincidence that can be linked. Careful work-up of children with UPJO and urolithiasis is recommended to exclude an underlying metabolic disease. Surgical correction can be evitable as treatment of the primary cause can lead to complete dissolution of kidney stones and improvement of the medical condition. 1. Introduction Ureteropelvic junction obstruction (UPJO) has a reported incidence of 1 in 500 live births [1], more commonly in males than females and more frequently found on the lef side. It can be congenital or acquired, but congenital cases are more common. It is considered the most common cause of antenatally detected hydronephrosis [2, 3]. Management of UPJO depends on symptoms and split renal function and it includes conservative management with observation and follow-up or surgical intervention. UPJO can lead to urolithiasis due to obstruction and urinary stasis; however, metabolic causes of urolithiasis should be investigated and ruled out [4–6]. We describe an unusual case of UPJO associated with PHTP and kidney stones. 2. Case Presentation In our manuscript, we report the case of a 15-year-old boy with a longstanding history of unilateral ureteropelvic junction obstruction who was presented for right fank pain of three-month duration. Te patient had been followed up for his right UPJO since birth, as he was diagnosed prenatally to have hydronephrosis. An early ultrasound imaging of the kidney was done at the age of three months and revealed a right renal pelvis dilatation of 15 mm (anteroposterior diameter) with normal kidney parenchyma. Later at the age of three years, a follow-up ultrasound noted an increased dilatation of the right pelvis up to 20 mm. Further studies were carried out; a MAG-3 scintigraphy was performed and showed a good contrast evacuation (10% residual radioac- tivity, 20 minutes afer furosemide injection) and symmetric kidney function (45% for the right kidney and 55% for the lef). Furthermore, the child was followed regularly with renal ultrasound that revealed a stationary course of pelvic dilation within 15–20 mm without any clinical manifestation. At the age of 15 years, the patient presented to our institution for right fank pain, without urinary symptoms. Renal ultrasound showed bilateral kidney stones (8 to 9 mm). A CT-scan of the abdomen showed a moderately dilated right pelvis of 19 mm containing three stones, in addition to two stones in a nondilated lef renal pelvis Hindawi Case Reports in Nephrology Volume 2017, Article ID 9852912, 4 pages https://doi.org/10.1155/2017/9852912