scholarly journals Snake Bite Presenting as Haemolytic Uremic Syndrome: A Rare Case Report

2021 ◽  
Author(s):  
Parth Godhiwala ◽  
Sourya Acharya ◽  
Amol Andhale ◽  
Samarth Shukla ◽  
Sunil Kumar
Keyword(s):  
Kidney Injury ◽  
Snake Bite ◽  
Health Issues ◽  
Haemolytic Uremic Syndrome ◽  
Tubular Necrosis ◽  
Rare Case Report ◽  
Uremic Syndrome ◽  
Tubular Toxicity ◽  
Stage Renal Disease ◽  
End Stage

Snake bite is predominantly an occupational hazard and causes severe health issues. Snake poisoning in India is a significant and prevalent cause of Acute Kidney Injury (AKI). In India, the occurrence of AKI after snake bite is 13-32%. All over the world every year, 1,50,000 people die as a result of it. Multiple mechanisms such as haemodynamic disturbances, direct tubular toxicity, coagulopathy, haemoglobinuria, and myoglobinuria can cause AKI after bites by snakes belonging to the Elapidae, Viperidae, and Colubridae families. Renal pathologic findings include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. Thrombotic Microangiopathy (TMA) as a cause of snakebite-induced AKI is rarely reported in literature. Fewer details are known about the clinical course, optimal management, and overall prognosis of this entity. Haemolytic Uremic Syndrome (HUS) is a clinical disease that includes TMA, thrombocytopenia, and AKI as a triad. The HUS is a heterogeneity of illnesses with diverse aetiology which results in presentation, therapy and outcomes variance. Hereby, authors report a case of a 55-year-old female who was bitten by Russell’s viper and developed HUS. Patient eventually progressed to end stage renal disease and was advised lifelong haemodialysis. TMA should be taken into account as a probable cause of AKI following a snake bite. Plasma exchanges have yet to be determined in snake bite TMA.

scholarly journals De Novo Atypical Haemolytic Uremic Syndrome after Kidney Transplantation

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Arnaud Devresse ◽  
Martine de Meyer ◽  
Selda Aydin ◽  
Karin Dahan ◽  
Nada Kanaan
Keyword(s):  
Kidney Transplantation ◽  
De Novo ◽  
Alternative Pathway ◽  
Factor H ◽  
Complement Factor ◽  
Haemolytic Uremic Syndrome ◽  
Hinman Syndrome ◽  
Uremic Syndrome ◽  
Stage Renal Disease ◽  
End Stage

De novo thrombotic microangiopathy (TMA) can occur after kidney transplantation. An abnormality of the alternative pathway of complement must be suspected and searched for, even in presence of a secondary cause. We report the case of a 23-year-old female patient who was transplanted with a kidney from her mother for end-stage renal disease secondary to Hinman syndrome. Early after transplantation, she presented with 2 episodes of severe pyelonephritis, associated with acute kidney dysfunction and biological and histological features of TMA. Investigations of the alternative pathway of the complement system revealed atypical haemolytic uremic syndrome secondary to complement factor I mutation, associated with mutations in CD46 and complement factor H related protein genes. Plasma exchanges followed by eculizumab injections allowed improvement of kidney function without, however, normalization of creatinine.

scholarly journals Cystatin C in the diagnostics of acute kidney injury after heart transplantation

2017 ◽  
Vol 19 (1) ◽  
pp. 17-21
Author(s):  
A. G. Strokov ◽  
Ya. L. Poz ◽  
V. N. Poptsov ◽  
A. O. Shevchenko ◽  
N. P. Shmerko
Keyword(s):  
Acute Kidney Injury ◽  
Heart Transplantation ◽  
Cystatin C ◽  
Kidney Injury ◽  
Circulatory Support ◽  
Tubular Necrosis ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Urinary Cystatin C

Aim. To examine the assumption that significant concentrations of cystatin C in urine are the manifestation of the tubular necrosis and, respectively, the severity of kidney damage after heart transplantation (HTx).Materials and methods. In this study we evaluated 33 heart recipients (6 women and 27 men, aged from 24 to 68 years old) who had risk factors of acute kidney injury: serum creatinine level >113 μmol/l and/or mechanical circulatory support requirement (20 patients, in 14 cases before HTx). Cystatin C concentration in serum and in urine was measured by DyaSis particle-enhanced immunoturbidimetric assay test «Cystatin C FS».Results. Recipients were divided into two groups according to the levels of cystatinuria. In the group with the significant (more than 0.18 mg/l) urinary cystatin C concentrations the requirement of renal replacement therapy (RRT) was 2.5-fold higher, and the mean duration of RRT was more than 10-fold longer. In 2 patients with the significant cystatinuria acute kidney injury (AKI) has transformed into end-stage renal disease (ESRD).Conclusion. Due to data obtained we may suppose that significant concentrations of cystatin C in urine are the marker of the tubular necrosis with the prolonged RRT requirement. Further studies are needed to justify this relationship.

scholarly journals Snakebite Induced Thrombotic Microangiopathy Leading to Renal Cortical Necrosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ying Mao Gn ◽  
Arvind Ponnusamy ◽  
Vikram Thimma
Keyword(s):  
Thrombotic Microangiopathy ◽  
Kidney Injury ◽  
Cortical Necrosis ◽  
Mortality And Morbidity ◽  
Renal Cortical Necrosis ◽  
Tubular Necrosis ◽  
Renal Manifestation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Fibrin Thrombi

Renal complications from snakebite result in high mortality and morbidity. Acute kidney injury (AKI) occurs in 5–30% of cases. Renal manifestation could include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. We present a case of thrombotic microangiopathy (TMA) resulting in renal cortical necrosis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis. Our patient progressed to end-stage renal disease.

scholarly journals Atypical hemolytic uremic syndrome: A report of two cases

2016 ◽  
Vol 9 (1) ◽  
pp. 75
Author(s):  
Md. Habibur Rahman ◽  
Morsheda Akhter ◽  
Syed Symul Haque
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Course Of Illness ◽  
Atypical Hus ◽  
Excellent Outcome ◽  
Uremic Syndrome ◽  
Stage Renal Disease ◽  
End Stage ◽  
Insight Into

Hemolytic uremic syndrome (HUS) is one of the important cause of acute kidney injury in children. There is excellent outcome in patients with typical HUS but atypical HUS is associated with high mortality, risk of recurrence and may lead to end stage renal disease. We report two cases of 5 and 6 year old child having clinical & laboratory characteristics of atypical HUS. These children had a fulminant course of illness with complications involving various systems. The report provides an insight into the etio pathogenesis, diagnoses and treatment of this condition.

Other toxic acute tubulointerstitial nephritis

2015 ◽  
Author(s):  
Benjamin J. Freda ◽  
Gregory L. Braden
Keyword(s):  
Ethylene Glycol ◽  
Tubulointerstitial Nephritis ◽  
Kidney Injury ◽  
Calcium Deposition ◽  
Tubulointerstitial Injury ◽  
Tubular Toxicity ◽  
Ethylene Glycol Intoxication ◽  
Renal Tubular ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease (CKD) is often the result of incomplete recovery of renal function from a variety of causes of acute tubulointerstitial injury. Exposure to ethylene glycol, chlorinated hydrocarbons, paraquat, or toxic mushrooms often causes severe acute kidney injury (AKI), leading to chronic tubulointerstitial nephritis (TIN) and CKD, including end-stage renal disease. Ethylene glycol intoxication often leads to chronic TIN and CKD from direct renal tubular toxicity and from interstitial calcium oxalate deposition. Chlorinated hydrocarbon exposure can cause dialysis-dependent AKI, but only rarely causes CKD from interstitial calcium deposition. Paraquat intoxication causes dose-dependent AKI and often Fanconi syndrome in up to 50% of patients, but only 15% of these patients survive, so CKD is rarely seen as a complication. The toxic mushrooms Cortinarius and Amanita phalloides often cause delayed AKI leading to CKD, chronic dialysis, or renal transplantation.

scholarly journals Acute Tubular Necrosis after Ingestion of a Fertilizer Containing Sodium Silicate

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Hyeon Woo Lee ◽  
Yong Jun Choi ◽  
Se Won Oh ◽  
Hye Kyeong Park ◽  
Kum Hyun Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Sodium Silicate ◽  
Acute Tubular Necrosis ◽  
Lung Fibrosis ◽  
Kidney Biopsy ◽  
Kidney Injury ◽  
Inflammatory Cells ◽  
Tubular Necrosis ◽  
Stage Renal Disease ◽  
End Stage

Silica nephropathy occurs after chronic heavy exposure to silica, resulting in the development of chronic kidney disease and progression to end-stage renal disease. However, acute kidney injury due to silica exposure is rare and its renal pathology remains unclear. Here, we report a case of acute sodium silica poisoning presenting as acute kidney injury. A 42-year-old man ingested a fertilizer containing sodium silicate. His serum creatinine increased by 5.06 mg/dL from 1.1 mg/dL 2 days after silicate ingestion. Owing to the decline in kidney function despite fluid therapy, a kidney biopsy was performed. The kidney showed acute tubular necrosis without infiltration of inflammatory cells. On day 5 of admission, hemodialysis was initiated to treat the hyperkalemia and oliguria, and treatment with methylprednisolone was initiated for the acute lung injury. The patient was administered 1 mg/kg of methylprednisolone intravenously daily for 2 weeks, followed by a 2-week taper. Hemodialysis was discontinued on day 10 and the patient’s renal function recovered completely. However, he died on day 40 of hospitalization owing to complicated lung fibrosis and persistent pneumothorax/pneumomediastinum.

Atypical hemolytic uremic syndrome & treatment: case study

2021 ◽  
pp. 1-7
Author(s):  
Azhar Ali Khan ◽  
Muhammad Usman Ahraf ◽  
Usman Javaid
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Daily Basis ◽  
Fresh Frozen Plasma ◽  
Atypical Hus ◽  
Fresh Frozen ◽  
Uremic Syndrome ◽  
Stage Renal Disease ◽  
End Stage

Abstract Atypical Hemolytic Uremic Syndrome (aHUS) is considered as an uncommon pathology that usually affects young adults and causes acute kidney injury which can further lead to End Stage Renal Disease (ESRD). Atypical HUS usually occurs due to impairment in alternate pathway of complement system. aHUS are usually sporadic and less than 20% cases are familial. About 50% aHUS cases show no clear initiating factors. Mortality rate has been reduced in atypical HUS over the years due to progress in intensive care and dialysis facility. First treatment option should be PE, with exchange of 1.5 plasma volumes (60-75 ml/kg) per session, under the cover of fresh frozen plasma (FFP). PE needs to be performed on daily basis while waiting for the results of platelet count, LDH and Hb levels to be normal and renal functions showing improvement. Here we present a case in 15-year-old boy who was healthy previously. Continuous...

scholarly journals A complex case of fatal calciphylaxis in a female patient with hyperparathyroidism secondary to end stage renal disease of graft and coexistence of haemolytic uremic syndrome

2012 ◽  
Vol 156 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Attilio Ignazio Lo Monte ◽  
Maurizio Bellavia ◽  
Giuseppe Damiano ◽  
Maria Concetta Gioviale ◽  
Carolina Maione ◽  
...  
Keyword(s):  
Renal Disease ◽  
Female Patient ◽  
End Stage Renal Disease ◽  
Complex Case ◽  
Haemolytic Uremic Syndrome ◽  
Uremic Syndrome ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Quantification and Dosing of Renal Replacement Therapy in Acute Kidney Injury: A Reappraisal

2017 ◽  
Vol 44 (2) ◽  
pp. 140-155 ◽  
Author(s):  
William R. Clark ◽  
Martine Leblanc ◽  
Zaccaria Ricci ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Journal Club ◽  
Kidney Injury ◽  
Accurate Estimation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Dose Assessments ◽  
Solute Clearance

Background/Aims: Delivered dialysis therapy is routinely measured in the management of patients with end-stage renal disease; yet, the quantification of renal replacement prescription and delivery in acute kidney injury (AKI) is less established. While continuous renal replacement therapy (CRRT) is widely understood to have greater solute clearance capabilities relative to intermittent therapies, neither urea nor any other solute is specifically employed for CRRT dose assessments in clinical practice at present. Instead, the normalized effluent rate is the gold standard for CRRT dosing, although this parameter does not provide an accurate estimation of actual solute clearance for different modalities. Methods: Because this situation has created confusion among clinicians, we reappraise dose prescription and delivery for CRRT. Results: A critical review of RRT quantification in AKI is provided. Conclusion: We propose an adaptation of a maintenance dialysis parameter (standard Kt/V) as a benchmark to supplement effluent-based dosing of CRRT. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=475457

Sign in / Sign up

Export Citation Format

Share Document