Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 48-year-old man with idiopathic hypereosinophilic syndrome (IHS) developed blast crisis along with a fulminant autoimmune hemolytic anemia. Hemoglobinuria and anuric acute renal failure (ARF) ensued. Urinalysis revealed countless Charcot-Leyden crysals (CLC). This is the only known report of Charcot-Leyden crystalluria. The CLC protein (lysophospholipase) should normally undergo glomerular filtration and catabolism by the tubules during reabsorption. Its abundant presence in the urine of our patient may reflect impairment of tubular reabsorption, saturation of the tubular reabsorptive process by excessive CLC load through residual functioning glomeruli, or a combination thereof. The extreme degree of hypereosinophilia suggests a massive load of CLC protein and acute tubular necrosis implies impaired tubular function, so both mechanisms should have been operative. At the autopsy, no eosinophilic infiltrates were present in the kidneys, which points against a local spillage of CLC protein into the tubules.
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PMID:Urinary Charcot-Leyden crystals in the hypereosinophilic syndrome with acute renal failure. 317 75

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been implicated as a cause of acute liver failure, acute renal failure, and acute autoimmune hemolytic anemia. Since NSAIDs are capable of causing serious injury to multiple organ systems, it is surprising that no one has observed multisystem involvement in any of the described patients. We describe two patients with multisystem involvement presumed to be secondary to NSAIDs. Both patients had renal failure consistent with acute tubular necrosis. Both patients had liver failure, one with hepatocellular disease and the other with a cholestatic picture. One patient had a Coombs'-positive hemolytic anemia.
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PMID:Acute multisystem toxicity associated with the use of nonsteroidal anti-inflammatory drugs. 670 23

Worldwide use of herbal therapy has increased dramatically in recent years. Most herbal therapies were not regulated as medicines, and their adverse effects often were underreported. We report a patient who developed acute renal failure, acute hepatic failure, autoimmune hemolytic anemia, and thrombocytopenia after oral intake of hot-water extract of Cupressus funebris Endl (Mourning Cypress), which is rich in flavonoids. Her renal biopsy showed acute tubular necrosis, interstitial nephritis, and hemoglobin casts. The clinical course and pathological findings were consistent with flavonoid-induced acute nephropathy. We emphasize that flavonoids are not harmless and may induce acute life-threatening renal damage.
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PMID:Flavonoid-induced acute nephropathy by Cupressus funebris Endl (Mourning Cypress). 1705 87