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( Ha Nee Jang ),( Kyungo Hwang ),( Min Jeong Kim ),( Dae Hong Jeon ),( Hyun Jung Kim ),( Hyun Seop Cho ),( Se Ho Chang ),( Dong Jun Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
It is known that commonly prescribed drugs are associated with hemolytic uremic syndrome (HUS) manifested with microanigopathic hemolytic anemia (MAHA), thrombocytopenia, and acute renal failure. Rifampicin may cause hemolysis, thrombocytopenia, and acute renal failure. However, rifampicin associated HUS has been rarely reported. We report a case of HUS in a patient taking rifampicin. A 74-year-old woman was admitted to our hospital due to azotemia aggravation. Her previous medical history included leprosy (30yr), HT (5yr), and angina pectoris (5yr). Her medication has not been changed during recent 5 years except for recent start of rifampicin 450 mg per day 5 days before. Laboratory findings revealed MAHA, thrombocytopenia, elevated reticulocyte count and lactate dehydrogenase (LDH), and lower haptoglobin level. Her serum creatinine level was increased to 6.68 mg/dL. In addition to immediate withdrawal of rifampicin medication, three times of hemodialysis and ten times of consecutive plasma exchange improved her renal function and restored above abnormal laboratory findings. She is currently following to the outpatient clinic without renal impairment. We should keep in mind that rifampicin is one of drug to induce HUS.
Anuric Acute Renal Failure Associated with Pericardial Effusion without Signs of Cardiac Tamponade
Seo, Jong Woo,Kang, Yeojin,Bae, Eun Jin,Hwang, Kyungo,Cho, Hyun Seop,Chang, Se-Ho,Park, Dong Jun Informa Healthcare 2012 Renal failure Vol.34 No.8
<P>This article describes the anuric acute renal failure (ARF) secondary to massive pericardial effusion without tamponade in an 84 year-old man. He was referred to our emergency room with progressive dyspnea and azotemia. An electrocardiogram showed sinus tachycardia. A two-dimensional echocardiogram confirmed the presence of severe pericardial effusion without prominent ventricular diastolic collapse and there were no changes in his vital signs. Laboratory findings showed that his blood urea nitrogen and serum creatinine levels were 91.8 and 3.77 mg/dL, respectively. Renal ultrasonography showed no signs of hydronephrosis. Urine output did not increase in spite of giving a saline and furosemide infusion but increased immediately after pericardiocentesis with drainage. His renal function was completely restored 3 days after the procedure. A pericardial biopsy demonstrated invasion of malignant cells. We should keep in mind that pericardial effusion is one of the causes of anuric ARF, although it is not accompanied by tamponade.</P>