| A case of acute renal failure in a patient with paroxysmal nocturnal hemoglobinuria |
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Hyun Kyung Nam, Hyun Seung Yoo, Won Suk An, Seong Eun Kim, Sung-Hyun Kim, Seo Hee Rha, Seong Kuk Yoon |
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| 발작성 야간혈색소뇨증에서 발생한 급성 신부전증 |
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남현경·유현승·안원석·김성은·김성현·나서희·윤성국, Hyun Seung Yoo, Won Suk An, Seong Eun Kim, Sung-Hyun Kim, Seo Hee Rha, Seong Kuk Yoon |
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| Abstract |
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Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired chronic hemolytic anemia characterized by persistent intravascular
hemolysis. The kidneys are subject to acute failure or chronic injury in association with ischemia, intravascular hemolysis, and hemosiderin
deposition; however the pathogenesis of renal failure has not been clearly defined. In Korea, there has been 1 case of
acute renal failure with PNH demonstrated by MRI and a kidney biopsy. A 39-year-old female patient with PNH who received low
dose oral prednisolone for 2 years developed oliguric acute renal failure after 2 days of fever and sore throat. The serum LDH level
was elevated, and indirect bilirubinemia was noted. A renal biopsy showed features of acute tubular necrosis and hemosiderosis.
Magnetic resonance imaging revealed characteristic features of renal hemosiderosis. There was no evidence of either renal vein
thrombosis or cortical infarct. Her renal function became stabilized with hemodialysis and intravenous fluid, and she recovered 4
weeks later. (Korean J Med 77:S1231-S1236, 2009) |
| Key Words:
Paroxysmal nocturnal hemoglobinuria; Acute renal failure; Biopsy; Magnetic resonance imaging |
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