Loading...
Please wait, while we are loading the content...
Similar Documents
Paroxysmal nocturnal hemoglobinuria presenting as acute renal failure.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mijares, R. P. Praga, Manuel Izaguirre, A. Angulo, Paul Urquizu, C. Novales, Eduardo López De |
| Copyright Year | 1984 |
| Abstract | R.P. Mijares, MD, Servicio de Nefrología, Hospital Nuestra Señora de Aranzazu, Universidad del Pais Vasco, Alto de Zorroaga, San Sebastián (Spain) Dear Sir, The role of hemoglobin in the pathogenesis of acute renal failure (ARF) remains obscure. ARF has been described in paroxysmal cold hemoglobinuria [1] and in other intravascular hemolytic anemias following bouts of severe hemoglobinuria. In paroxysmal nocturnal hemoglobinuria (PNH), progressive declining of renal function has been observed in some patients [2], but very few patients have been recorded as ARF [3, 4]. Even in these we feel there is no clear – cut evidence to show that the spontaneous hemolytic crises were the cause of ARF. We report a case of severe ARF in a patient with previously unknown PNH in which this relationship is clearly defined. Case Report On April 26, 1982, a 30-year-old woman was hospitalized because of abdominal pain, dark urine, and oliguria; these symptoms have begun 36 h before. 1 month earlier she had dark urine for 48 h, without other complaints. She denied fever, rash, arthritis, drug intake, or physical exercise. The patient was alert and well hydrated; the temperature was 36.7 °C, the pulse 84/min, and the blood pressure 130/80 mm Hg. Physical examination was normal. Laboratory data on admission showed: blood urea nitrogen (BUN) 20 mg/l00 ml, serum sodium 139 mEq/1, potassium 3.9, chloride 108 mEq/1 hematocrit 30%, hemoglobin 10.7 g/l00 ml, leukocyte count 3,600/mm3 with normal differential count, no eosinophils were seen, platelet count 75,000/mm3, total bilirubin 3.6 mg/l00 ml, reticulocytes 2%, the haptoglobin was undetectable, the urine gave a + + + test for hemoglobin and hemosiderin and + for protein, the sediment contained granular casts, and an urine culture was negative. She was treated with intravenous fluids and furosemide, but the daily urine output remained below 100 ml, and BUN and serum creatinine (Cr) increased progressively. On April 30 the hematocrit was 21%, BUN 102 mg/l00 ml, and Cr 8.5 mg/l00 ml. The proteinu-ria averaged 300–500 mg/24 h. Echography ruled out renal obstruction. Acidified seerum test (Ham’s test) and sucrose hemolysis test were repaetedly positive. She received prednisone, 0.5 mg/kg, in tapering doses. Cryoglobulins and antinuclear antibodies |
| Starting Page | 69 |
| Ending Page | 70 |
| Page Count | 2 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://www.karger.com/Article/Pdf/183283 |
| PubMed reference number | 6472536v1 |
| Volume Number | 38 |
| Issue Number | 1 |
| Journal | Nephron |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Abdominal Pain Acute kidney injury Alert:Type:Point in time:^Patient:Nominal Anemia, Hemolytic Arthritis Bilirubin Blood urea nitrogen measurement Chloride Ion Chromosome Deletion Contain (action) Creatinine measurement, serum (procedure) Cryoglobulins Disseminated Intravascular Coagulation Erythroblastosis, Fetal Exanthema Exercise Fever Furosemide Granular Cast Measurement Haptoglobins Hemolysis (disorder) Kidney Diseases Kidney Failure, Acute Leukocytes Mercury Obstruction Oliguria Paroxysmal nocturnal hemoglobinuria Patients Platelet Count measurement Potassium Prednisone Radioimmunoassay Reifenstein Syndrome Renal Insufficiency Reticulocyte count (procedure) Serum sodium measurement Sucrose Tapering - action Ultrasonography White Blood Cell Count procedure |
| Content Type | Text |
| Resource Type | Article |
