Pigment cast nephropathy; time to revisit the diagnosis

Ahmed Waheed Kashif; Toyaja Jadhav; Sanjay Kimar Panda

doi:10.34172/jnp.2021.14

J Nephropathol. 2021;10(2): e14.
doi: 10.34172/jnp.2021.14

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Brief Report

Pigment cast nephropathy; time to revisit the diagnosis

Ahmed Waheed Kashif ¹ * , Toyaja Jadhav ¹ , Sanjay Kimar Panda ¹

¹ Department of Pathology, Armed Forces Medical College, Maharashtra University of Health Sciences, Pune, India

Abstract

Pigment cast nephropathy is one of the most severe complications of rhabdomyolysis. It is an important cause of renal failure requiring renal replacement therapy. We report the case of a 23-year-old man who presented with short febrile illness with hyperpyrexia and altered sensorium. Non-contrast CT-brain and CSF analysis were normal. He later developed petechial rashes with thrombocytopenia followed by frank hematuria and worsening renal functions. A kidney biopsy was performed, which revealed findings of myoglobin cast nephropathy

Keywords: Myoglobin cast nephropathy, Rhabdomyolysis, Pigment cast nephropathy, Renal failure, Renal replacement therapy, Acute kidney injury, Myoglobinuria

Implication for health policy/practice/research/medical education: In this study we report a case of a 23-year-old man who presented with hyperpyrexia, altered sensorium and developed deranged renal function. A kidney biopsy was performed, which revealed findings of myoglobin cast nephropathy. Pigment cast nephropathy is a raredisorder and is often misdiagnosed. Our case was unique as he had varied clinical presentation with an underlying pigment cast nephropathy.A timely diagnosis and management lead to a good outcome in this case.

Please cite this paper as: Kashif AW, Jadhav T, Panda SK. Pigment cast nephropathy; time to revisit the diagnosis. J Nephropathol. 2021;10(2):e14. DOI: 10.34172/jnp.2021.14.

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