Rhabdomyolysis in a case of free-base cocaine ("crack") overdose.

1989 ◽  
Vol 35 (7) ◽  
pp. 1547-1549 ◽  
Author(s):  
M A Jandreski ◽  
E W Bermes ◽  
R Leischner ◽  
S E Kahn
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Crack Cocaine ◽  
Clinical Course ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Blood Chemistry ◽  
Free Base ◽  
Laboratory Findings ◽  
Remarkable Recovery

Abstract This is the case of a 27-year-old black man who was admitted to Loyola University Medical Center after a one-time experience of smoking free-base ("crack") cocaine. Clinical manifestations of the resulting cocaine intoxication were rhabdomyolysis, acute renal failure, and transient liver failure. This patient came to our attention because of the striking alterations in his blood-chemistry values, which indicated acute tissue damage, and his remarkable recovery within 96 h. We discuss the dramatic changes in the laboratory findings and the clinical course of this patient.

The Importance of Nonrenal Involvement in Hemolytic-Uremic Syndrome

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 115-120
Author(s):  
Kirti Upadhyaya ◽  
Kenneth Barwick ◽  
Mark Fishaut ◽  
Michael Kashgarian ◽  
Norman J. Siegel
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Hemolytic Uremic Syndrome ◽  
Clinical Course ◽  
Important Determinant ◽  
Clinical Manifestations ◽  
Wide Distribution ◽  
Effective Management ◽  
Uremic Syndrome ◽  
The Brain

Fifteen children with the clinical manifestations of hemolytic-uremic syndrome are reported.Prompt recognition of the syndrome and effective therapy for acute renal failure including early dialysis were institured in each case. Analysis of the clinical course and histopathologic features in these patients indicated that early dialysis and effective management of acute renal failure may unmask evidence of nonrenal involvement; microthrombi may be found in a wide distribution of organs, including the brain and myocardium; and extent and severity of nonrenal involvement become an important determinant of ultimate prognosis.

scholarly journals A Case of Multiple Myeloma Diagnosed by Renal Biopsy

2016 ◽  
Vol 14 (2) ◽  
pp. 89-91
Author(s):  
Lutfiye Bilge Caliskan ◽  
Tugba Karadeniz ◽  
Sumeyye Ekmekci ◽  
Banu Yilmaz Avcioglu ◽  
Mehmet Tanrisev ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Clinical Case ◽  
Bone Fractures ◽  
Cell Clone ◽  
Clinical Manifestations ◽  
Peripheral Blood Smear ◽  
Laboratory Findings ◽  
Cast Nephropathy

Abstract Multiple myeloma is a malignant disease that results in the proliferation of a single plasma cell clone. The clinical manifestations are anemia, bone pain, bone fractures, hypercalcemia, hypergammaglobulinemia, increased erythrocyte sedimentation rate, rouleaux formation on the peripheral blood smear and rarely increased serum viscosity. Rarely cast nephropathy associated with acute renal failure may be the first finding of multiple myeloma. We report a clinical case of a 44-year-old female patient who presented with acute renal failure due to cast nephropathy without myeloma’s typical clinical and laboratory findings. In the clinical case presented here, we highlight that multiple myeloma can be presented with acute renal failure and without any other typical symptoms.

scholarly journals Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

2005 ◽  
Vol 47 (6) ◽  
pp. 315-320 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Geraldo Bezerra da Silva Júnior ◽  
Marúsia Thomaz Ferreira ◽  
Fernando Antonio de Sousa Barros ◽  
Tiago Magalhães Gurgel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
Human Rabies ◽  
Tubular Necrosis ◽  
Post Mortem Findings ◽  
Histopathologic Findings

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

Acute Tubular Necrosis: Diagnosis, Treatment, and Nursing Implications

1992 ◽  
Vol 3 (3) ◽  
pp. 688-697
Author(s):  
Sara Douglas
Keyword(s):  
At Risk ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Acute Tubular Necrosis ◽  
Early Recognition ◽  
Recovery Phase ◽  
Vital Role ◽  
Laboratory Findings ◽  
Tubular Necrosis

Acute tubular necrosis (ATN) is the most common cause of acute renal failure. Early recognition of patients who are at risk for ATN can prevent or improve the course of ATN. Acute renal failure is classified as prerenal, intrinsic, or postrenal disease. ATN is classified as a type of intrinsic renal disease. The clinical course of ATN is divided into the renal failure phase, diuretic phase, and recovery phase, with each phase having distinct symptoms and laboratory findings. Diagnosis of ATN often is complicated and confusing; understanding of laboratory findings can facilitate the critical care nurse’s ability to assess those at risk for ATN. The care and treatment of the patient with ATN is complicated, and specific treatments are discussed in detail. The critical care nurse can play a vital role in identifying the patient at risk, preventing the development of ATN in those at risk, and providing appropriate care for those who develop ATN

scholarly journals Nephronophthisis and medullary cystic kidney disease complex

2005 ◽  
Vol 62 (9) ◽  
pp. 683-688
Author(s):  
Marijana Stanisic ◽  
Rajko Hrvacevic ◽  
Zoran Paunic ◽  
Stanko Petrovic
Keyword(s):  
Renal Failure ◽  
Kidney Disease ◽  
Ultrasound Examination ◽  
Clinical Manifestations ◽  
Cystic Kidney Disease ◽  
Cystic Kidney ◽  
Laboratory Findings ◽  
Disease Complex ◽  
Terminal Renal Failure ◽  
Medullary Cystic Kidney Disease

Background. Nephronophthisis and medullary cystic kidney disease complex refers to the genetic heterogeneous group of inherited tubulointerstital nephritis. Nephronophthisis comprises at last 3 clinical manifestations, has the autosomal recessive pattern of inheritance, appears early in life and is the most frequent inherited kidney disease that causes terminal renal failure in childhood, while medullary cystic kidney disease has the autosomal dominant pattern of inheritance, is less frequent, and terminal renal failure appears later in life. These two forms have similar clinical and morphological findings but extrarenal manifestations, the median ages of occurrence of terminal renal failure, and siblings presence help us distinguish these diseases. Case report. In this article we illustrated the case of a 20- years old patient with the suspicion of having complex nephornophthisis and medullary cystic kidney disease based upon mild renal failure, seen in routinely taken laboratory findings and bilateral cysts in corticomedullary region of the kidneys verified on abdominal ultrasound examination. Conclusion. This disease should rise suspicion in children or adolescents with progressive renal failure, a typical clinical manifestation, blood and urine samples results, bilateral cysts in the corticomedullary region of the kidneys seen during ultrasound examination of the kidneys and family inheritance.

scholarly journals Acute Renal Failure in a Patient with Rivaroxaban-Induced Hypersensitivity Syndrome: A Case Report with a Review of the Literature and of Pharmacovigilance Registries

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Gisela Marcelino ◽  
Ould Maouloud Hemett ◽  
Eric Descombes
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Adverse Events ◽  
Case Reports ◽  
Vitamin K Antagonists ◽  
Clinical Manifestations ◽  
Hypersensitivity Syndrome ◽  
World Health ◽  
Low Grade ◽  
Review Of The Literature

Direct oral anticoagulants (DOACs) are among the most commonly prescribed medications, and DOAC-associated kidney dysfunction may be a problem that is underrecognized by clinicians. We report on the case of an 82-year-old patient who, two weeks after the prescription of rivaroxaban for atrial fibrillation, was hospitalized for a drug-induced hypersensitivity syndrome whose main clinical manifestations were low-grade fever with a petechial rash in the legs and acute renal failure (ARF). Within one week after rivaroxaban withdrawal, the patient’s clinical condition improved and the renal function normalized. In a review of the literature, we only found five case reports of rivaroxaban-related ARF: two patients had tubulo-interstitial nephritis (TIN), two had anticoagulant-related nephropathy (ARN), and the last one had IgA nephropathy. As some recent publications suggest that kidney injury due to anticoagulation drugs may be largely underdiagnosed, we also analyzed the data from the VigiAccess database, the World Health Organization pharmacovigilance program that collects drug-related adverse events from 134 national registries worldwide. Among all the rivaroxaban-associated adverse events reported in VigiAccess since 2006, 4,323 (3.5%) were renal side effects, of which 2,351 (54.3%) were due to unspecified ARF, 363 (8.4%) were due to renal hemorrhage (characteristically associated with ARN), and 24 (0.6%) were due to TIN. We also compared these results with those reported in VigiAccess for other DOACs and vitamin K antagonists. This analysis suggests that the frequency of renal adverse events associated with rivaroxaban and other DOACs may be appreciably higher than what one might currently consider based only on the small number of fully published cases.

IDIOPATHIC PAROXYSMAL MYOGLOBINURIA

PEDIATRICS ◽  
1959 ◽  
Vol 23 (1) ◽  
pp. 12-17
Author(s):  
William E. Segar
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Mortality Rate ◽  
Clinical Manifestations ◽  
Unknown Etiology ◽  
Definite Diagnosis ◽  
Absorption Bands ◽  
Pathologic Process ◽  
Complete Paralysis ◽  
Spectroscopic Examination

A case of idiopathic paroxysmal myoglobinuria is reported. This is a disease of unknown etiology, characterized by severe muscle pain and weakness or complete paralysis and by the excretion of burgundycolored urine. The urine is free of erythrocytes but gives a strongly positive benzidine reaction. There is no discoloration of the plasma. A definite diagnosis can be made by spectroscopic examination of the urinary pigment and identification of the absorption bands characteristic of myoglobin. The underlying pathologic process and clinical manifestations are discussed. This report describes the treatment of a 15-year-old boy who recovered despite the development of both respiratory paralysis and acute renal failure, complications which are responsible for the mortality rate of 30% from this disorder.

scholarly journals Potential Benefit of Plasma Exchange in Treatment of Severe Icteric Leptospirosis Complicated by Acute Renal Failure

2002 ◽  
Vol 9 (2) ◽  
pp. 482-484 ◽  
Author(s):  
Kai-Chung Tse ◽  
Pok-Siu Yip ◽  
King-Men Hui ◽  
Fu-Keung Li ◽  
Kwok-Yung Yuen ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Plasma Exchange ◽  
Cell Function ◽  
Clinical Manifestations ◽  
Renal Tubular Cell ◽  
Beneficial Effects ◽  
Hemorrhagic Tendency ◽  
Renal Tubular ◽  
Severe Hyperbilirubinemia

ABSTRACT Leptospirosis is a common zoonosis seen worldwide, but it is rare in our locality (Hong Kong). Clinical manifestations of leptospirosis are variable and may range from subclinical infection to fever, jaundice, hemorrhagic tendency, and fulminant hepato-renal failure. Severe hyperbilirubinemia and acute renal failure have been associated with high mortality. We report our experience with a patient who developed severe Weil's syndrome with marked conjugated hyperbilirubinemia and oliguric acute renal failure. These complications persisted despite treatment with penicillin and hemodiafiltration. Plasma exchange was instituted in view of the severe hyperbilirubinemia (970 μmol/liter). This was followed by prompt clinical improvement, with recovery of liver and renal function. The beneficial effects of plasma exchange could be attributed to amelioration of the toxic effects of hyperbilirubinemia on hepatocyte and renal tubular cell function. We conclude that plasma exchange should be considered as an adjunctive therapy for patients with severe icteric leptospirosis complicated by acute renal failure who have not shown rapid clinical response to conventional treatment.

scholarly journals Health after Legionnaires' disease: A description of hospitalizations up to 5 years after Legionella pneumonia

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245262
Author(s):  
Shantini D. Gamage ◽  
Natasha Ross ◽  
Stephen M. Kralovic ◽  
Loretta A. Simbartl ◽  
Gary A. Roselle ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Chronic Conditions ◽  
Medical Center ◽  
Case Series ◽  
Retrospective Case ◽  
Icu Admission ◽  
Case Series Study ◽  
Legionnaires Disease

Background and objectives Research on Legionnaires’ Disease (LD) suggests there may be long-term health complications, but data are limited. This study investigated whether Intensive Care Unit (ICU) admission during LD hospitalization may be associated with adverse health outcomes and characterized subsequent discharge diagnoses in patients with LD up to 5 years post-LD. Methods We conducted a retrospective case series study with follow up for 5 years among patients hospitalized at a Department of Veterans Affairs (VA) Medical Center between 2005 and 2010 with LD. Data were collected from medical records on health history, LD severity (including ICU admission), and discharge diagnoses for 5 years post-LD or until death. We used ordinal logistic regression to explore associations between ICU admission and hospitalizations post-LD. Frequency counts were used to determine the most prevalent discharge diagnoses in the 5 years post-LD. Results For the 292 patients with laboratory-confirmed LD, those admitted to the ICU during LD hospitalization were more likely to have a greater number of hospitalizations within 5 years compared to non-ICU patients (ORHosp 1.92 CI95% 1.25, 2.95). Fifty-five percent (161/292) had ≥ 1 hospitalization within 5 years post-LD. After accounting for pre-existing diagnosis codes in patients with at least one hospitalization in the 2 years prior to LD (n = 77/161 patients, 47.8%), three of the four most frequent new diagnoses in the 5 years post-LD were non-chronic conditions: acute renal failure (n = 22, 28.6%), acute respiratory failure (n = 17, 22.1%) and unspecified pneumonia (n = 15, 19.5%). Conclusions Our findings indicate that LD requiring ICU admission is associated with more subsequent hospitalizations, a factor that could contribute to poorer future health for people with severe LD. In addition to chronic conditions prevalent in this study population, we found new diagnoses in the 5-year post-LD period including acute renal failure. With LD incidence increasing, more research is needed to understand conditions and factors that influence long term health after LD.

scholarly journals Crotalus Durissus Ruruima: Current Knowledge on Natural History, Medical Importance, and Clinical Toxinology

2021 ◽  
Vol 12 ◽  
Author(s):  
Manuela B. Pucca ◽  
Paulo Sérgio Bernarde ◽  
Anderson Maciel Rocha ◽  
Patrik F. Viana ◽  
Raimundo Erasmo Souza Farias ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Natural History ◽  
Respiratory Muscle ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Muscle Paralysis ◽  
Medical Importance ◽  
Crotalus Durissus

Crotalus durissus ruruima is a rattlesnake subspecies mainly found in Roraima, the northernmost state of Brazil. Envenomings caused by this subspecies lead to severe clinical manifestations (e.g. respiratory muscle paralysis, rhabdomyolysis, and acute renal failure) that can lead to the victim’s death. In this review, we comprehensively describe C. d. ruruima biology and the challenges this subspecies poses for human health, including morphology, distribution, epidemiology, venom cocktail, clinical envenoming, and the current and future specific treatment of envenomings by this snake. Moreover, this review presents maps of the distribution of the snake subspecies and evidence that this species is responsible for some of the most severe envenomings in the country and causes the highest lethality rates. Finally, we also discuss the efficacy of the Brazilian horse-derived antivenoms to treat C. d. ruruima envenomings in Roraima state.

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