The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report
<p>Abstract</p> <p>Introduction</p> <p>Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular inte...
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| Format: | Article |
| Language: | English |
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BMC
2009-01-01
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| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/3/1/20 |
| _version_ | 1811295342544551936 |
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| author | Qian Yimei Mehandru Sushil K Gornish Nancy Frank Elliot |
| author_facet | Qian Yimei Mehandru Sushil K Gornish Nancy Frank Elliot |
| author_sort | Qian Yimei |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature.</p> <p>Case presentation</p> <p>A 60-year-old Indian-American woman with a history of hypertension and diabetes mellitus for 10 years presented with progressive oliguria over 2 days. Laboratory data revealed severe hyperkalemia, azotemia, heavy proteinuria and progressively worsening anemia. Urine eosinophils were not seen. Emergent hemodialysis, erythropoietin and blood transfusion were initiated. Serologic tests for hepatitis B, hepatitis C, anti-nuclear antibodies, anti-glomerular basement membrane antibodies and anti-neutrophil cytoplasmic antibodies were negative. Complement levels (C3, C4 and CH50) were normal. Renal biopsy unexpectedly displayed 100% foot process effacement. A 24-hour urine collection detected 6.38 g of protein. Proteinuria and anemia resolved during six weeks of steroid therapy. Renal function recovered completely. No signs of relapse were observed at 8-month follow-up.</p> <p>Conclusion</p> <p>Adult minimal change disease should be considered when a patient presents with proteinuria and severe acute kidney injury even when accompanied by severe anemia. This report adds to a growing body of literature suggesting that in addition to steroid therapy, prompt initiation of erythropoietin therapy may facilitate full recovery of renal function in acute kidney injury.</p> |
| first_indexed | 2024-04-13T05:31:58Z |
| format | Article |
| id | doaj.art-382b105943a24872a18a399098fed6a3 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T05:31:58Z |
| publishDate | 2009-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-382b105943a24872a18a399098fed6a32022-12-22T03:00:24ZengBMCJournal of Medical Case Reports1752-19472009-01-01312010.1186/1752-1947-3-20The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case reportQian YimeiMehandru Sushil KGornish NancyFrank Elliot<p>Abstract</p> <p>Introduction</p> <p>Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature.</p> <p>Case presentation</p> <p>A 60-year-old Indian-American woman with a history of hypertension and diabetes mellitus for 10 years presented with progressive oliguria over 2 days. Laboratory data revealed severe hyperkalemia, azotemia, heavy proteinuria and progressively worsening anemia. Urine eosinophils were not seen. Emergent hemodialysis, erythropoietin and blood transfusion were initiated. Serologic tests for hepatitis B, hepatitis C, anti-nuclear antibodies, anti-glomerular basement membrane antibodies and anti-neutrophil cytoplasmic antibodies were negative. Complement levels (C3, C4 and CH50) were normal. Renal biopsy unexpectedly displayed 100% foot process effacement. A 24-hour urine collection detected 6.38 g of protein. Proteinuria and anemia resolved during six weeks of steroid therapy. Renal function recovered completely. No signs of relapse were observed at 8-month follow-up.</p> <p>Conclusion</p> <p>Adult minimal change disease should be considered when a patient presents with proteinuria and severe acute kidney injury even when accompanied by severe anemia. This report adds to a growing body of literature suggesting that in addition to steroid therapy, prompt initiation of erythropoietin therapy may facilitate full recovery of renal function in acute kidney injury.</p>http://www.jmedicalcasereports.com/content/3/1/20 |
| spellingShingle | Qian Yimei Mehandru Sushil K Gornish Nancy Frank Elliot The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report Journal of Medical Case Reports |
| title | The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report |
| title_full | The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report |
| title_fullStr | The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report |
| title_full_unstemmed | The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report |
| title_short | The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report |
| title_sort | first description of severe anemia associated with acute kidney injury and adult minimal change disease a case report |
| url | http://www.jmedicalcasereports.com/content/3/1/20 |
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