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Lozano Chinga M, Afify Z, Lowichik A, Grinsell MM, Seamon M, Meznarich JA. Female adolescent with recurrent anemia and thrombocytopenia: Answers. Pediatr Nephrol 2022; 37:2069-2071. [PMID: 35275276 DOI: 10.1007/s00467-022-05486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Michell Lozano Chinga
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Utah Health and Primary Children's Hospital, 100 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA
| | - Zeinab Afify
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Utah Health and Primary Children's Hospital, 100 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA
| | - Amy Lowichik
- Division of Pathology, University of Utah Health and Primary Children's Hospital, Salt Lake City, UT, USA
| | - Matthew M Grinsell
- Division of Pediatric Nephrology, Department of Pediatrics, University of Utah Health and Primary Children's Hospital, Salt Lake City, UT, USA
| | - Meredith Seamon
- Division of Pediatric Nephrology, Department of Pediatrics, University of Utah Health and Primary Children's Hospital, Salt Lake City, UT, USA
| | - Jessica A Meznarich
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Utah Health and Primary Children's Hospital, 100 N Mario Capecchi Drive, Salt Lake City, UT, 84113, USA.
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Matsuoka N, Watanabe H, Kurooka N, Kato S, Higashi C, Tanabe K, Kinomura M, Fujii N, Sada KE, Sugiyama H, Wada J. Acute Kidney Injury Caused by Evans Syndrome with Systemic Lupus Erythematosus and Systemic Sclerosis. Intern Med 2021; 60:1055-1060. [PMID: 33116016 PMCID: PMC8079912 DOI: 10.2169/internalmedicine.5976-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 65-year-old woman with systemic sclerosis and systemic lupus erythematosus developed acute kidney injury (AKI), Coombs-positive autoimmune hemolytic anemia and autoimmune thrombocytopenia; therefore, she was diagnosed with Evans syndrome (ES). Intravascular hemolysis was suggested as the cause of AKI based on the presence of acute tubular injury and trace hemosiderin deposits on the renal biopsy. The renal function, hemolytic anemia and thrombocytopenia were restored by an increased dose of glucocorticoids, hemodialysis, and plasma exchange. Although ES with severe hemolytic anemia is very rare, it is important to detect possible renal dysfunction when encountering patients with severe hemolysis.
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Affiliation(s)
- Natsumi Matsuoka
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Haruki Watanabe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Naoko Kurooka
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Sumari Kato
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Chika Higashi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Katsuyuki Tanabe
- Division of Hemodialysis and Apheresis, Okayama University Hospital, Japan
| | - Masaru Kinomura
- Division of Hemodialysis and Apheresis, Okayama University Hospital, Japan
| | - Nobuharu Fujii
- Department of Transfusion Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Ken-Ei Sada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Hitoshi Sugiyama
- Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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Gaut JP, Liapis H. Acute kidney injury pathology and pathophysiology: a retrospective review. Clin Kidney J 2020; 14:526-536. [PMID: 33623675 PMCID: PMC7886540 DOI: 10.1093/ckj/sfaa142] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Indexed: 12/12/2022] Open
Abstract
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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Affiliation(s)
- Joseph P Gaut
- Department of Pathology and Immunology and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Helen Liapis
- Department of Pathology and Immunology and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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Couri FS, Kandula M. A Case of Evans Syndrome with Acute Hemolysis and Hemoglobin Cast Nephropathy. Am J Case Rep 2020; 21:e920760. [PMID: 32029698 PMCID: PMC7020757 DOI: 10.12659/ajcr.920760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Patient: Male, 60-year-old Final Diagnosis: Evans syndrome Symptoms: Back pain Medication:— Clinical Procedure: — Specialty: Hematology
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Affiliation(s)
- Felicia Sadie Couri
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA
| | - Manasa Kandula
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA
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