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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2018  |  Volume : 29  |  Issue : 5  |  Page : 1232-1236
Hemosiderin tubulopathy-induced acute kidney injury - A rare initial manifestation of paroxysmal nocturnal hemoglobinuria


1 Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
2 Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
3 Department of Pathology and Lab Medicine, Manipal Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Sindhura Lakshmi Koulmane Laxminarayana
Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal - 576 104, Udupi
India
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DOI: 10.4103/1319-2442.243958

PMID: 30381527

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Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by episodes of intravascular hemolysis, infections, and thromboembolic complications. Renal abnormalities are rare which occur either due to hemolytic crisis or repeated thrombotic episodes involving small venules. Acute kidney injury (AKI) requiring hemodialysis due to toxic effects of hemoglobinuria, with a stable disease is exceptional. We describe a case of an elderly gentleman presenting with features of severe AKI requiring hemodialysis due to hemosiderin tubulotoxicity as the first manifestation of PNH. The diagnosis was challenging because of the rarity and unfamiliarity with this entity. The outcome was complete recovery of renal function with hemodialysis.


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