Open AccessG6PD deficiency is not an uncommon cause of pigment nephropathy
Author(s) -
Anupma Kaul,
Pallavi Prasad,
Niraj Kumari,
Dharmendra Bhaduaria,
RK Sharma,
Narayan Prasad,
Amit Gupta,
Narendra Krishnani
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 - 10.4103/1319-2442.248316
Subject(s) - medicine , thrombotic microangiopathy , acute kidney injury , hemolysis , jaundice , acute tubular necrosis , glucosephosphate dehydrogenase deficiency , nephropathy , hemolytic anemia , anemia , rasburicase , liver biopsy , microangiopathy , malaria , glucose 6 phosphate dehydrogenase deficiency , biopsy , intensive care medicine , diabetes mellitus , immunology , kidney , chemotherapy , endocrinology , disease , biochemistry , chemistry , enzyme , glucose 6 phosphate dehydrogenase , tumor lysis syndrome , dehydrogenase
Acute kidney injury (AKI) with evidence of hemolysis is associated with tropical infections. However, pigment-induced AKI can happen with relatively uncommon genetic causes of hemolytic anemia, i.e., glucose 6-phosphate deficiency (G6PD). We share our experience of three such patients whose clinical presentation was similar to jaundice, AKI with hemolysis with suspicion of thrombotic microangiopathy. On evaluation, all had a history of usage of anti-malarial and with G6PD estimation revealing deficient status even during the episode while other tests such as Coomb's test and bone marrow biopsy was normal in all three patients. The kidney biopsy revealed acute tubular necrosis with red blood cell casts and pigments in all the cases. All patients were managed conservatively and showed complete recovery. Thus in tropical countries G6PD deficiency although is not common, should be considered among patients who have received antimalarial drugs presenting as AKI and a detailed hemolytic work-up needs to be carried out as an important cause of preventable recurrent AKI in tropical countries.