Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
Case Reports
Acute Kidney Injury Related to Muscle Breakdown-Not All Due to Rhabdomyolysis: A Case of Acute Urate Nephropathy
Author(s): Oluwaseun Oluwo*, Anita Vincent-Johnson and Kambiz Kalantari
A young man with a history of pseudo-seizures was admitted after an episode of severe agitation and rigorous physical activity. The patient was febrile on admission with notable leukocytosis and lactic acidosis but a negative infectious workup. During the hospitalization, the patient developed severe Acute Kidney Injury (AKI) despite fluid hydration. Creatinine Phosphoryl Kinase (CPK) was minimally elevated at 693 U/l. Urine
microscopy was significant for many uric acid crystals. Subsequent lab studies revealed an elevated uric acid level of 13.4 mg/dl with fractional excretion of urate (Fe-Urate) of 13%. The patient was treated with rasburicase and allopurinol with the improvement of AKI that paralleled the improvement in hyperuricemia. AKI was likely due to acute urate nephropathy from a pseudo-seizure. AKI following an icteric activity or rigorous physical activity can occ.. Read More»
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