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Post-renal acute kidney injury complicated by urinary tract obstruction due to massive blood clots and severe thrombocytopenia in a patient with systemic lupus erythematosus: A case report.
- Source :
-
Modern rheumatology case reports [Mod Rheumatol Case Rep] 2024 Jul 08; Vol. 8 (2), pp. 272-275. - Publication Year :
- 2024
-
Abstract
- Systemic lupus erythematosus (SLE) is often seen with antiphospholipid antibody syndrome (APS), and these conditions may occur concurrently with severe immune thrombocytopenia (ITP) and even acute kidney injury (AKI); however, post-renal AKI due to bleeding is uncommon. Here, we describe a case of post-renal AKI and anuria in a patient with SLE and APS, which were attributable to urinary tract obstruction due to massive blood clots caused by secondary ITP. A 50-year-old Japanese woman was admitted to our hospital with anuria, abdominal tenderness, purpura in the trunk and in both legs, and severe thrombocytopenia. She had been receiving medical treatment for APS and SLE till the age of 45 years. Computed tomography revealed a blood clot without extravasation in both urinary tracts, and she was diagnosed with post-renal AKI due to complete obstruction of the urinary system. Additionally, based on her medical history, elevated platelet-associated Immunoglobulin G (IgG) levels, and increased megakaryocyte count, she was diagnosed with secondary ITP complicated by SLE and APS. She also had elevated APS-related autoantibodies, including antiphosphatidylserine/prothrombin Immunoglobulin M (IgM), and IgG. However, concomitant serositis such as lupus enteritis or cystitis was not seen. She was treated with a combination of glucocorticoids, intravenous immunoglobulin, and continuous haemodialysis/haemofiltration, which resulted in rapid improvement of her symptoms and renal dysfunction. Secondary ITP-induced massive bleeding of urinary tract can cause post-renal AKI. Appropriate diagnosis and aggressive treatment are necessary to improve prognosis in such patients.<br /> (© Japan College of Rheumatology 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)
- Subjects :
- Humans
Female
Middle Aged
Thrombocytopenia etiology
Thrombocytopenia diagnosis
Thrombocytopenia complications
Antiphospholipid Syndrome complications
Antiphospholipid Syndrome diagnosis
Thrombosis etiology
Thrombosis diagnosis
Treatment Outcome
Lupus Erythematosus, Systemic complications
Lupus Erythematosus, Systemic diagnosis
Acute Kidney Injury etiology
Acute Kidney Injury diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2472-5625
- Volume :
- 8
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Modern rheumatology case reports
- Publication Type :
- Academic Journal
- Accession number :
- 38479844
- Full Text :
- https://doi.org/10.1093/mrcr/rxae014