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  • Title: [Acute renal failure in a case of paroxysmal nocturnal hemoglobinuria--a review of literature in Japan].
    Author: Kondo H, Uga S, Kaihara A, Kawada M, Yamano T.
    Journal: Nihon Jinzo Gakkai Shi; 1990 Jul; 32(7):835-40. PubMed ID: 2273600.
    Abstract:
    A case of paroxysmal nocturnal hemoglobinuria (PNH) associated with acute renal failure (ARF) is described. A 57-year-old female, who had been diagnosed as having PNH in 1983 at Kochi Medical School, was admitted to our hospital in April 1989, because of ARF with dark urine after a common cold. Hemodialysis was performed 5 times for ARF, and after almost completely recovering from ARF, she was discharged. The renal biopsy showed the deposition of hemosiderin in the proximal tubular cells. We surveyed fourteen case reports of PNH associated with ARF in Japan including our case. Ten cases developed ARF after infection causing hemolytic attack. Twelve of 14 cases were treated by hemodialysis and 13 cases were reversible. The histopathology of their renal biopsies revealed the deposition of hemosiderin in the proximal tubular cells in six of seven cases and tubular necrosis in three cases. These data showed that hemolytic attack and dehydration related to infection facilitated the induction of ARF.
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