Open AccessAcute kidney injury: A rare cause
Author(s) -
Satish Mendonca,
Satish Barki,
Mayank Mishra,
Richa Kumar,
Devika Gupta,
Pooja Gupta
Publication year - 2015
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.164583
Subject(s) - myoglobinuria , medicine , rhabdomyolysis , acute kidney injury , acute tubular necrosis , flaccid paralysis , hemoperfusion , renal function , dialysis , myotoxin , paralysis , surgery , anesthesia , hemodialysis , phospholipase a2 , biochemistry , chemistry , enzyme
We present a young lady who consumed hair dye, which contained paraphenylene diamine (PPD), as a means of deliberate self-harm. This resulted in severe angio-neurotic edema for which she had to be ventilated, and thereafter developed rhabdomyolysis leading to acute kidney injury (AKI). The unusual aspect was that the patient continued to have flaccid quadriparesis and inability to regain kidney function. Renal biopsy performed 10 weeks after the dye consumption revealed severe acute tubular necrosis with myoglobin pigment casts. This suggests that PPD has a long-term effect leading to ongoing myoglobinuria, causing flaccid paralysis to persist and preventing the recovery of AKI. In such instances, timely treatment to prevent AKI in the form alkalinization of urine should be initiated promptly. Secondly, because PPD is a nondialyzable toxin, and its long-term effect necessitates its speedy removal, hemoperfusion might be helpful and is worth considering.