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Recurrent acute renal failure.

Satish S, Rajesh R, Kurian G, Seethalekshmi NV, Unni M, Unni VN - Indian J Nephrol (2010)

Bottom Line: While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare.We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, India.

ABSTRACT
While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

No MeSH data available.


Related in: MedlinePlus

Kidney biopsy: Light microscopy with Perlaes stain (Prussian blue stain) showing uptake of stain by intratubular casts as well as tubular cells
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Figure 0003: Kidney biopsy: Light microscopy with Perlaes stain (Prussian blue stain) showing uptake of stain by intratubular casts as well as tubular cells

Mentions: Urinalysis showed 1 + protein, blood 2 + by dipstick, no RBCs on microscopy, Hb 9 g%, total leukocyte count 12,000/mm3, platelet count 3,00,000/mm3. Serum creatinine 3.2 mg%. Total bilirubin was 3 mg%, indirect 2.0 mg%. AST/ALT/Alkaline phosphatase and serum albumin were normal. Chest x-ray and ultrasonogram of abdomen were normal. ANA and ASO titre were negative and urine culture sterile. Serum complement levels were normal. Peripheral smear showed mild to moderate anisopoikilocytosis, scattered spherocytes, schistocytes and polychromasia. The reticulocyte count was 3.3%. Osmotic fragility, Hb electrophoresis and G 6 PD levels were normal. Coombs test was negative. The renal function worsened after admission and the patient remained oliguric. Hence a kidney biopsy was performed. Kidney biopsy showed normal glomeruli, acute tubular necrosis with prominent pigment casts [Figure 1] which stained blue with Prussian blue stain (Perl’s stain) [Figure 2a and 2b]. Immunofluorescence was negative. Renal functions improved with conservative management over the course of next one week and the patient was discharged, with serum creatinine of 1.8 mg%; he did not undergo dialysis.


Recurrent acute renal failure.

Satish S, Rajesh R, Kurian G, Seethalekshmi NV, Unni M, Unni VN - Indian J Nephrol (2010)

Kidney biopsy: Light microscopy with Perlaes stain (Prussian blue stain) showing uptake of stain by intratubular casts as well as tubular cells
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3008954&req=5

Figure 0003: Kidney biopsy: Light microscopy with Perlaes stain (Prussian blue stain) showing uptake of stain by intratubular casts as well as tubular cells
Mentions: Urinalysis showed 1 + protein, blood 2 + by dipstick, no RBCs on microscopy, Hb 9 g%, total leukocyte count 12,000/mm3, platelet count 3,00,000/mm3. Serum creatinine 3.2 mg%. Total bilirubin was 3 mg%, indirect 2.0 mg%. AST/ALT/Alkaline phosphatase and serum albumin were normal. Chest x-ray and ultrasonogram of abdomen were normal. ANA and ASO titre were negative and urine culture sterile. Serum complement levels were normal. Peripheral smear showed mild to moderate anisopoikilocytosis, scattered spherocytes, schistocytes and polychromasia. The reticulocyte count was 3.3%. Osmotic fragility, Hb electrophoresis and G 6 PD levels were normal. Coombs test was negative. The renal function worsened after admission and the patient remained oliguric. Hence a kidney biopsy was performed. Kidney biopsy showed normal glomeruli, acute tubular necrosis with prominent pigment casts [Figure 1] which stained blue with Prussian blue stain (Perl’s stain) [Figure 2a and 2b]. Immunofluorescence was negative. Renal functions improved with conservative management over the course of next one week and the patient was discharged, with serum creatinine of 1.8 mg%; he did not undergo dialysis.

Bottom Line: While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare.We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, India.

ABSTRACT
While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

No MeSH data available.


Related in: MedlinePlus