A Rare Cause of Reversible Renal Hemosiderosis

Arkoub, Rima Abou; Don, Wang; Zimmerman, Deborah

doi:10.1155/2015/464059

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…Some cases of infectious hemosiderosis may be reversible. For example, while Clostridium difficile– induced hemolysis may be complicated by hemoglobinuria-induced ATI, rarely is hemosiderosis reported; these deposits may resolve with resolution of the infection [ 18 ]. Supratherapeutic doses of Coumadin and other blood thinners (e.g., dabigatran) should also be excluded in patients with artificial valves or heart disease since anticoagulation is routinely prescribed.…”

Section: Aki Perspectivementioning

confidence: 99%

Acute kidney injury pathology and pathophysiology: a retrospective review

Gaut

Liapis

2020

Clinical Kidney Journal

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Acute kidney injury (AKI) is the clinical term used for decline or loss of renal function. It is associated with chronic kidney disease (CKD) and high morbidity and mortality. However, not all causes of AKI lead to severe consequences and some are reversible. The underlying pathology can be a guide for treatment and assessment of prognosis. The Kidney Disease: Improving Global Outcomes guidelines recommend that the cause of AKI should be identified if possible. Renal biopsy can distinguish specific AKI entities and assist in patient management. This review aims to show the pathology of AKI, including glomerular and tubular diseases.

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Section: Aki Perspectivementioning

confidence: 99%

Acute kidney injury pathology and pathophysiology: a retrospective review

Gaut

Liapis

2020

Clinical Kidney Journal

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“…In PNH, AKI can be a consequence of intravascular hemolysis from the increased destruction of red blood cells and release of free hemoglobin [88]. A similar manifestation can be found in all those conditions where hemosiderin deposits induce acute tubular necrosis: in those cases, upon the hemolysis of erythrocytes, hemoglobin alpha-beta dimers are liberated and filtered by glomeruli, causing hemoglobinuria [89].…”

Section: Acute Kidney Injury and Dialysis Choices In Pnh-a Nephrologist's Opinionmentioning

confidence: 94%

Complement Inhibition Therapy and Dialytic Strategies in Paroxysmal Nocturnal Hemoglobinuria: The Nephrologist’s Opinion

Gembillo

Siligato

Cernaro

et al. 2020

JCM

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Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal disease that presents an estimated incidence of 1.3 cases per million per year, with a prevalence of 15.9 cases per million. It is characterized by hemolysis, bone marrow dysfunction with peripheral blood cytopenia, hypercoagulability, thrombosis, renal impairment and arterial and pulmonary hypertension. Hemolysis and subsequent hemosiderin accumulation in tubular epithelium cells induce tubular atrophy and interstitial fibrosis. The origin of PNH is the somatic mutation in the X-linked phosphatidylinositol glycan class A (PIG-A) gene located on Xp22: this condition leads to the production of clonal blood cells with a deficiency in those surface proteins that protect against the lytic action of the activated complement system. Despite the increased knowledge of this syndrome, therapies for PNH were still only experimental and symptomatic, until the introduction of the C5 complement blockade agent Eculizumab. A second generation of anti-complement agents is currently under investigation, representing future promising therapeutic strategies for patients affected by PNH. In the case of chronic hemolysis and renal iron deposition, a multidisciplinary approach should be considered to avoid or treat acute tubular injury or acute kidney injury (AKI). New promising perspectives derive from complement inhibitors and iron chelators, as well as more invasive treatments such as immunoadsorption or the use of dedicated hemodialysis filters in the presence of AKI.

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Are Clostridium difficile toxins nephrotoxic?

Cimolai

2019

Medical Hypotheses

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A Rare Cause of Reversible Renal Hemosiderosis

Cited by 4 publications

References 15 publications

Acute kidney injury pathology and pathophysiology: a retrospective review

Acute kidney injury pathology and pathophysiology: a retrospective review

Complement Inhibition Therapy and Dialytic Strategies in Paroxysmal Nocturnal Hemoglobinuria: The Nephrologist’s Opinion

Are Clostridium difficile toxins nephrotoxic?

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