Open AccessHemosiderin tubulopathy-induced acute kidney injury - A rare initial manifestation of paroxysmal nocturnal hemoglobinuria
Author(s) -
Satish Rao,
Sindhura Lakshmi Koulmane Laxminarayana,
Shankar Prasad Nagaraju,
Mahesha Vankalakunti,
Ravindra Prabhu Attur,
Chethan Manohar
Publication year - 2018
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 - 10.4103/1319-2442.243958
Subject(s) - medicine , hemosiderin , paroxysmal nocturnal hemoglobinuria , hemoglobinuria , acute kidney injury , tubulopathy , hemodialysis , eculizumab , kidney disease , anemia , gastroenterology , pathology , immunology , antibody , complement system
Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by episodes of intravascular hemolysis, infections, and thromboembolic complications. Renal abnormalities are rare which occur either due to hemolytic crisis or repeated thrombotic episodes involving small venules. Acute kidney injury (AKI) requiring hemodialysis due to toxic effects of hemoglobinuria, with a stable disease is exceptional. We describe a case of an elderly gentleman presenting with features of severe AKI requiring hemodialysis due to hemosiderin tubulotoxicity as the first manifestation of PNH. The diagnosis was challenging because of the rarity and unfamiliarity with this entity. The outcome was complete recovery of renal function with hemodialysis.