Hemolysis-Induced Acute Renal Failure in Paroxysmal Nocturnal Hemoglobinuria

Zeidman, Aliza; Chagnac, Avry; Wisnovitz, Meyer; Mittelman, Moshe

doi:10.1159/000187779

Cited by 5 publications

(4 citation statements)

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“…Chow et al [2] reviewed seven patients with PNH and acute renal failure (ARF) [1,[6][7][8]10]. Five of these patients were diagnosed to have PNH when they presented with ARF, as was the case with our patients.…”

Section: Discussionmentioning

confidence: 60%

“…Of these, the deficiency of decay-accelerating factor (DAF; CD55) and membrane inhibitor of reactive lysis (MIRL; CD59) renders the red blood cells particularly sensitive to lysis via the alternative pathway of complement activation. Although rare, both acute and chronic kidney involvement in PNH has been described in the literature [1][2][3][4][5][6][7][8][9][10][11]. Urinary tract infection and thrombosis of the renal vein are also known complications of PNH.…”

Section: Introductionmentioning

confidence: 99%

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Spectrum of renal involvement in paroxysmal nocturnal hemoglobinuria: report of three cases and a brief review of the literature

et al. 2008

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Renal involvement in paroxysmal nocturnal hemoglobinuria (PNH) is usually clinically not apparent but, in cases with clinical involvement, varies from reversible acute dysfunction to chronic irreversible damage. We report two cases of acute kidney injury and one case of chronic kidney disease due to PNH. In all three cases a diagnosis of PNH was made after detection of renal dysfunction. The renal involvement was documented on both histology and on imaging studies. Finally, we briefly review the main literature data on renal involvement in PNH.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Spectrum of renal involvement in paroxysmal nocturnal hemoglobinuria: report of three cases and a brief review of the literature

et al. 2008

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“…The cancellation of the elections and the prohibition of the FIS by the military radicalized some parts of the FIS and sparked off a civil war in which some 100,000 people were killed. 45 This civil war involved a great number of Algerian Islamists who fought previously in Afghanistan-denoted Algerian Afghans-and who were reported to have come back in great numbers.…”

Section: Algeriamentioning

confidence: 99%

Underlying Causes of Violence in the Middle East

Salih¹

2007

Digest Mid East Studies

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In the last five decades the Middle East has been the scene of very intensive conflict, violence and terror. The magnitude of violence has intensified following the events of September 11, 2001. There has been an outpouring of writing and scholarship that focuses on the analysis of this phenomenon. This paper attempts to reveal the major factors that have contributed to the state of violence in the Middle East. The paper argues that the failure of most of the Middle Eastern regimes to widen the arena of political participation, as well as their inabilities to improve the socio‐economic conditions of the masses, has been the major cause for violence. Adding to this the US global strategy to fight terror, and subsequently the invasion of Iraq, as well as the failure to reconcile the Palestinian issue also precipitated the state of violence in the Middle East. It is only after redressing the socio‐economic and political grievances of the masses, and finding remedies to both the Palestinian and Iraqi issues that we can contemplate the idea of a peaceful and stable Middle East. In this article, the author will attempt to address each of these factors.

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“…5 There are 3 additional reports of patients with hemoglobin casts that were not definitively characterized by IHC. These reports were described in patients with paroxysmal cold hemoglobinuria, 6 paroxysmal nocturnal hemoglobinuria, 7 and Evans syndrome. 8 This study aims to analyze more comprehensively the clinicopathologic characteristics of HAHCN utilizing a cohort of patients who had renal biopsies reviewed in our laboratory.…”

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confidence: 98%

Hemolysis-associated hemoglobin cast nephropathy results from a range of clinicopathologic disorders

Dvanajscak

Walker

Cossey

et al. 2019

Kidney International

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Intravascular hemolysis is relatively rare but can lead to acute kidney injury (AKI), from increased destruction of erythrocytes and release of free hemoglobin. Since hemolysis and hemoglobinuria are known causes of acute kidney injury we sought to define clinicopathologic findings and outcomes of patients with hemolysisassociated hemoglobin cast nephropathy through a retrospective analysis of 27 cases. The mean patient age was 47 years (range 19-79) and the female-to-male ratio was 1.3:1. All patients presented with AKI with a mean serum creatinine of 8.0 (range 2.9-17.0) mg/dL. Etiologies included autoimmune hemolytic anemia (30%), medication (26%), paroxysmal nocturnal hemoglobinuria (7%), procedural/mechanical causes (7%), transfusion of incompatible blood (4%), toxin ingestion (4%), disseminated intravascular coagulation (4%), and hemoglobinopathy (4%). All biopsies showed acute tubular injury and pigmented, proteinaceous casts characterized by positive hemoglobin immunohistochemistry. After a mean follow-up of nine months (range 0.5-26), the mean serum creatinine was 1.3 (range 0.6-3.3) mg/dL, with 78% of patients returning to normal kidney function. Thus, based on our clinicopathologic case series, hemolysisassociated hemoglobin cast nephropathy is an important entity for clinicians and pathologists to recognize as treatment hinges upon elimination of the pathogenic driver of intravascular hemolysis.

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Hemolysis-Induced Acute Renal Failure in Paroxysmal Nocturnal Hemoglobinuria

Cited by 5 publications

References 4 publications

Spectrum of renal involvement in paroxysmal nocturnal hemoglobinuria: report of three cases and a brief review of the literature

Spectrum of renal involvement in paroxysmal nocturnal hemoglobinuria: report of three cases and a brief review of the literature

Underlying Causes of Violence in the Middle East

Hemolysis-associated hemoglobin cast nephropathy results from a range of clinicopathologic disorders

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