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Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report
BACKGROUND: Although the renal toxicity of Deferasirox, an oral iron chelator, has been reported to be mild, there have been reports of acute interstitial nephritis or Fanconi syndrome due to this agent. Thin basement membrane disease (TBMD) is a hereditary disease characterized primarily by hematur...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298017/ https://www.ncbi.nlm.nih.gov/pubmed/30558557 http://dx.doi.org/10.1186/s12882-018-1180-2 |
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author | Oda, Keiko Katayama, Kan Tanoue, Akiko Murata, Tomohiro Hirota, Yumi Mizoguchi, Shoko Hirabayashi, Yosuke Ito, Takayasu Ishikawa, Eiji Dohi, Kaoru Ito, Masaaki |
author_facet | Oda, Keiko Katayama, Kan Tanoue, Akiko Murata, Tomohiro Hirota, Yumi Mizoguchi, Shoko Hirabayashi, Yosuke Ito, Takayasu Ishikawa, Eiji Dohi, Kaoru Ito, Masaaki |
author_sort | Oda, Keiko |
collection | PubMed |
description | BACKGROUND: Although the renal toxicity of Deferasirox, an oral iron chelator, has been reported to be mild, there have been reports of acute interstitial nephritis or Fanconi syndrome due to this agent. Thin basement membrane disease (TBMD) is a hereditary disease characterized primarily by hematuria, with gross hematuria also observed in about 7% of cases. We herein report a case of TBMD that presented with acute kidney injury and gross hematuria during treatment with Deferasirox. CASE PRESENTATION: The patient was a 63-year-old man who had been diagnosed with myelodysplastic syndrome 6 years ago. He had started taking Deferasirox at 125 mg due to post-transfusion iron overload 6 months ago. Deferasirox was then increased to 1000 mg three months ago. When the serum creatinine level increased, Deferasirox was reduced to 500 mg three weeks before hospitalization. Although the serum creatinine level decreased once, he developed a fever and macroscopic hematuria one week before hospitalization. The serum creatinine level increased again, and Deferasirox was stopped four days before hospitalization. He was admitted for the evaluation of acute kidney injury and gross hematuria. Treatment with temporary hemodialysis was required, and a kidney biopsy was performed on the eighth day of admission. Although there was no major abnormality in the glomeruli, the leakage of red blood cells into the Bowman’s space was observed. Erythrocyte cast formation was observed in the tubular lumen, which was associated with acute tubular necrosis. The results of an electron microscopic study were compatible with TBMD. CONCLUSION: Although Deferasirox is known to be nephrotoxic, gross hematuria is relatively rare. When we encounter a case of acute kidney injury with gross hematuria during treatment with Deferasirox, TBMD should be considered as a possible cause of gross hematuria. |
format | Online Article Text |
id | pubmed-6298017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62980172018-12-19 Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report Oda, Keiko Katayama, Kan Tanoue, Akiko Murata, Tomohiro Hirota, Yumi Mizoguchi, Shoko Hirabayashi, Yosuke Ito, Takayasu Ishikawa, Eiji Dohi, Kaoru Ito, Masaaki BMC Nephrol Case Report BACKGROUND: Although the renal toxicity of Deferasirox, an oral iron chelator, has been reported to be mild, there have been reports of acute interstitial nephritis or Fanconi syndrome due to this agent. Thin basement membrane disease (TBMD) is a hereditary disease characterized primarily by hematuria, with gross hematuria also observed in about 7% of cases. We herein report a case of TBMD that presented with acute kidney injury and gross hematuria during treatment with Deferasirox. CASE PRESENTATION: The patient was a 63-year-old man who had been diagnosed with myelodysplastic syndrome 6 years ago. He had started taking Deferasirox at 125 mg due to post-transfusion iron overload 6 months ago. Deferasirox was then increased to 1000 mg three months ago. When the serum creatinine level increased, Deferasirox was reduced to 500 mg three weeks before hospitalization. Although the serum creatinine level decreased once, he developed a fever and macroscopic hematuria one week before hospitalization. The serum creatinine level increased again, and Deferasirox was stopped four days before hospitalization. He was admitted for the evaluation of acute kidney injury and gross hematuria. Treatment with temporary hemodialysis was required, and a kidney biopsy was performed on the eighth day of admission. Although there was no major abnormality in the glomeruli, the leakage of red blood cells into the Bowman’s space was observed. Erythrocyte cast formation was observed in the tubular lumen, which was associated with acute tubular necrosis. The results of an electron microscopic study were compatible with TBMD. CONCLUSION: Although Deferasirox is known to be nephrotoxic, gross hematuria is relatively rare. When we encounter a case of acute kidney injury with gross hematuria during treatment with Deferasirox, TBMD should be considered as a possible cause of gross hematuria. BioMed Central 2018-12-17 /pmc/articles/PMC6298017/ /pubmed/30558557 http://dx.doi.org/10.1186/s12882-018-1180-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Oda, Keiko Katayama, Kan Tanoue, Akiko Murata, Tomohiro Hirota, Yumi Mizoguchi, Shoko Hirabayashi, Yosuke Ito, Takayasu Ishikawa, Eiji Dohi, Kaoru Ito, Masaaki Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title | Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title_full | Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title_fullStr | Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title_full_unstemmed | Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title_short | Acute kidney injury due to thin basement membrane disease mimicking Deferasirox nephrotoxicity: a case report |
title_sort | acute kidney injury due to thin basement membrane disease mimicking deferasirox nephrotoxicity: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298017/ https://www.ncbi.nlm.nih.gov/pubmed/30558557 http://dx.doi.org/10.1186/s12882-018-1180-2 |
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