{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T04:29:04Z","timestamp":1769747344030,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,15]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Bladder stones account for only 5% of urinary tract stones, and calcium tartrate tetrahydrate (CTT) stones are exceedingly rare. We present the case of a man in his early 60s with untreated diabetes, hypertension and chronic pesticide exposure, who developed a 24.1 mm \u00d7 35.6\u2009mm bladder stone. Stone analysis revealed 100% CTT composition, a finding reported predominantly in animal models and only rarely in humans. The patient\u2019s history of excessive consumption of energy drinks and supplements containing L-carnitine L-tartrate, combined with occupational pesticide exposure and neurogenic bladder, likely contributed to stone formation. This case highlights potential environmental and metabolic risk factors for CTT stones, including dietary tartrate, supplement use and chemical exposure. Recognition of such associations is crucial, as these stones pose diagnostic and therapeutic challenges. Further investigation is needed to clarify how dietary tartrate and occupational exposures may contribute to rare bladder stone pathogenesis.<\/jats:p>","DOI":"10.1136\/bcr-2025-270031","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:34Z","timestamp":1769697634000},"page":"e270031","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Calcium tartrate tetrahydrate bladder stone"],"prefix":"10.1136","volume":"19","author":[{"given":"Steele","family":"Netterville","sequence":"first","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Stevens","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5798-3121","authenticated-orcid":false,"given":"Preston Royce","family":"Barron","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared","family":"Moss","sequence":"additional","affiliation":[{"name":"Department of Urology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"2026012906402184000_19.1.e270031.1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1089\/cren.2017.0118","article-title":"Calcium Tartrate Tetrahydrate, Case Report of a Novel Human Kidney Stone","volume":"3","author":"Kleinguetl","year":"2017","journal-title":"J Endourol Case Rep"},{"key":"2026012906402184000_19.1.e270031.2","unstructured":"Leslie SW , Sajjad H , Murphy PB . Bladder Stones. StatPearls, Treasure Island (FL): StatPearls Publishing, 2025."},{"key":"2026012906402184000_19.1.e270031.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(05)70262-7"},{"key":"2026012906402184000_19.1.e270031.4","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.12968\/bjon.2001.10.22.9340","article-title":"Urinary tract stones: causes, complications and treatment","volume":"10","author":"Steggall","year":"2001","journal-title":"Br J Nurs"},{"key":"2026012906402184000_19.1.e270031.5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.urology.2019.01.005","article-title":"Uncovering a Novel Stone in 27 Patients: Calcium Tartrate Tetrahydrate","volume":"126","author":"Kleinguetl","year":"2019","journal-title":"Urology"},{"key":"2026012906402184000_19.1.e270031.6","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1107\/S0108768109013688","article-title":"Racemic calcium tartrate tetrahydrate [form (II)] in rat urinary stones","volume":"65","author":"Le Bail","year":"2009","journal-title":"Acta Crystallogr B"},{"key":"2026012906402184000_19.1.e270031.7","doi-asserted-by":"crossref","DOI":"10.3390\/nu13103432","article-title":"L-Carnitine Tartrate Supplementation for 5 Weeks Improves Exercise Recovery in Men and Women: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"13","author":"Stefan","year":"2021","journal-title":"Nutrients"},{"key":"2026012906402184000_19.1.e270031.8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4077\/CJP.2014.BAC198","article-title":"A mechanistic study on urine retention in d-amphetamine addicts","volume":"57","author":"Chiu","year":"2014","journal-title":"Chin J Physiol"},{"key":"2026012906402184000_19.1.e270031.9","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2010.00136","article-title":"Bladder dysfunction in diabetes mellitus","volume":"1","author":"Golbidi","year":"2010","journal-title":"Front Pharmacol"},{"key":"2026012906402184000_19.1.e270031.10","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-01732-2","article-title":"Urinary concentrations of neonicotinoid insecticides were related to renal tubular dysfunction and neuropsychological complaints in Dry-zone of Sri Lanka","volume":"11","author":"Taira","year":"2021","journal-title":"Sci Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:36Z","timestamp":1769697636000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-270031"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270031","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}