Cocaine-related acute renal failure without rhabdomyolysis

Abstract:

15-year-old girl presented with apparently unexplained acute renal failure. A renal biopsy was performed. Light microscopy showed no significant glomerular or vascular changes. Changes seen in the tubular interstitial compartment consisted of edema associated with subtle alterations in some proximal tubules, including vacuolation, apical fragmentation, desquamation of lining cells, and a rare mitotic figure. Ultrastructural examination confirmed these findings in the proximal tubules, where an activated lysosomal system was also identified. Immunohistochemistry for cocaine metabolitcs revealed staining in proximal tubular cells whereas immunohistochemistry for myoglobin was negative, indicating that cocaine was probably the culprit for the acute renal failure. This also suggested a different mechanism for the acute renal failure than myoglobinuria, the most common cause of cocaine-related acute renal failure …

Año de publicación:

1998

Keywords:

Fuente:

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