scholarly journals Rhabdomyolysis case based on hypothyroidism

Author(s):  
Bilal Katipoglu ◽  
Ihsan Ates ◽  
Fatih Acehan ◽  
Ayşenur Meteris ◽  
Nisbet Yılmaz

Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor drug compliance, which induced rhabdomyolysis. Our report emphasized that thyroid status should be evaluated in patients with unexplained acute renal impairment or presenting with the symptoms of muscle involvement.

2020 ◽  
Author(s):  
Omar maoujoud

Acute Kidney injury is relatively uncommon in COVID-19 patients yet carries a high mortality. It occurs in patients complicated with ARDS or multiorgan failure, but further investigation about inflammatory and apopotic mechanisms during renal impairment are needed. Since the development of AKI is an important negative prognostic indicator for survival with CoV as reported in previous SAR-CoV and MERS-CoV outbreaks, adequate medical management of high risk patients with AKI may improve the results of previous outbreaks related to CoV.


Author(s):  
Ravindra Rajakariar ◽  
Muhammad M. Yaqoob

Renal involvement in sarcoidosis is common and often under-recognized. The most frequent manifestation is acute kidney injury secondary to hypercalcaemia and granulomatous tubulointerstitial nephritis. The latter can lead to both acute kidney injury and to slowly progressive chronic renal impairment with concomitant chronic damage seen on histology. This chapter describes the types of renal disease that may occur in sarcoidosis and the pathogenesis, clinical presentation, diagnosis, and treatment of the patient with sarcoidosis. Corticosteroid therapy is the cornerstone of therapy. In patients with granulomatous tubulointerstitial nephritis, the authors recommend long-term, low-dose maintenance steroids.


Renal Failure ◽  
2011 ◽  
Vol 33 (8) ◽  
pp. 758-764 ◽  
Author(s):  
Chih-Chiang Chien ◽  
Hsien-Yi Wang ◽  
Jhi-Joung Wang ◽  
Wei-Chih Kan ◽  
Tsair-Wei Chien ◽  
...  

Critical Care ◽  
2015 ◽  
Vol 19 (1) ◽  
Author(s):  
Claire Rimes-Stigare ◽  
Paolo Frumento ◽  
Matteo Bottai ◽  
Johan Mårtensson ◽  
Claes-Roland Martling ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Paul D. Jewell ◽  
Kate Bramham ◽  
James Galloway ◽  
Frank Post ◽  
Sam Norton ◽  
...  

Abstract Background Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre. Methods We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020. Results Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24–4,18; p <  0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27–2.53; p <  0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19–2.13) for stage 1; p < 0.005, 2.71(95%CI 1.82–4.05); p < 0.001for stage 2 and 2.99 (95%CI 2.17–4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months. Conclusions This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3–6 months.


2020 ◽  
Author(s):  
Wim Vandenberghe ◽  
Lien Van Laethem ◽  
Alexander Zarbock ◽  
Melanie Meersch ◽  
Eric A.J. Hoste

AbstractIntroductionAcute kidney injury occurs in up to one third of patients after cardiac surgery and is an important contributor for adverse outcome. Previous research has demonstrated the benefit of a bundle of preventive measurements to reduce AKI in a subgroup of patients with high risk for AKI development. Urinary stress biomarkers [TIMP-2]*[IGFBP7] are used to identify these patients who are at risk for AKI. The trial aims to investigate the potential discrepancy between biomarker results and clinical estimation of occurrence of AKI on ICU in clinical practice.Methods and analysisWe plan to include 100 adult patients after cardiac surgery with cardiopulmonary bypass in a prospective, single center clinical trial. After cardiac surgery, different type of healthcare professional in ICU will provide a prediction of AKI occurrence and severity in the next 48 hours by filling in a questionnaire just before and after [TIMP-2]*[IGFBP7] biomarker analysis. Primary, this trial investigates the potential discrepancy in AKI prediction between clinical estimation by healthcare providers, biomarker results, and previous described score systems. Secondly, the impact of knowledge of the biomarker result on the quality of prediction by healthcare providers will be evaluated.Ethics and disseminationThis prospective, single center study has been approved by the medical ethical committee of the Ghent University Hospital (28th May 2019, trial registration number B670201939991). Informed consent was obtained for patients and healthcare providers.Summary strength and limitations-Influence of knowledge of a kidney biomarker on healthcare providers’ assessment of risk for AKI in clinical setting-Different types of healthcare providers with various expertise-It is a single center study with limited number of patients


Author(s):  
Ayesha Ghayur ◽  
Qurrat Elahi ◽  
Chinmay Patel ◽  
Rishi Raj

Summary Hypothyroidism is a common medical condition and is often easily managed with excellent outcomes, when treated adequately. Compliance with levothyroxine (LT4) therapy is often compromised because of the need for a daily and lasting schedule. Overt rhabdomyolysis due to under-treatment or non-compliance is a rare occurrence. We report a case of rhabdomyolysis leading to acute kidney injury (AKI) on chronic kidney disease (CKD) requiring hemodialysis (HD) in a 68-year-old Caucasian male due to non-compliance with levothyroxine (LT4) therapy. Our patient 'ran out of levothyroxine' for approximately 4 weeks and developed gradually progressive muscle pain. The diagnosis of severe AKI due to rhabdomyolysis was made based on oliguria, elevated creatinine kinase (CK), and renal failure. Resuming the home dose of LT4 failed to correct CK levels, and there was a progressive decline in renal function. Although increasing doses of LT4 and three cycles of HD improved CK levels, they remained above baseline at the time of discharge. The patient recovered gradually and required HD for 4 weeks. CK levels normalized at 6 weeks. Through this case report, we highlight that non-compliance with LT4 therapy can lead to life-threatening complications such as renal failure and hence the need to educate patients on the significance of compliance with LT4 therapy should be addressed. Learning points Non-compliance to levothyroxine therapy is common and can lead to serious complications, including rhabdomyolysis. Rhabdomyolysis is an uncommon presentation of hypothyroidism and severe rhabdomyolysis can result in renal failure requiring hemodialysis. Rhabdomyolysis associated with hypothyroidism can be further exacerbated by concomitant use of statins.


Reports ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. 11 ◽  
Author(s):  
Jayan George ◽  
Samuel Besant ◽  
Trevor Cleveland ◽  
Ahmed Al-Mukhtar

Inferior pancreaticoduodenal artery pseudoaneurysms and aneurysms are a rare occurrence, comprising of approximately 10% of visceral artery aneurysms and pseudoaneurysms. The cause is normally due to trauma, iatrogenic or pancreatitis. We present a case of a patient re-presenting to hospital following treatment of acute cholecystitis with epigastric pain, dysphagia, pyrexia, nausea, vomiting and an acute kidney injury. Following cholecystostomy, intravenous fluids and conservative treatment for her symptoms, she failed to improve significantly and was found to have a 6 mm pseudoaneurysm of the inferior pancreaticoduodenal artery on day twenty of her admission. She was transferred to a tertiary centre and was treated with an embolisation and recovered well from the procedure.


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