Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 10 2 2021 04 01 Pigment cast nephropathy; time to revisit the diagnosis e14 e14 10.34172/jnp.2021.14 EN Ahmed Waheed Kashif https://orcid.org/0000-0002-4289-8256 Toyaja Jadhav https://orcid.org/0000-0003-4571-7526 Sanjay Kimar Panda Journal Article 10.34172/jnp.2021.14 2020 04 03 2020 05 31 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