Acute Bilateral Renal Cortical Necrosis Associated with Diclofenac Sodium.
- Author:
Ji Chul YUN
1
;
Joo Eun BAEK
;
Eun Young JUNG
;
Dong Won LEE
;
Yi Yeong JEONG
;
Se Ho CHANG
;
Jong Deog LEE
;
Hyun Jung KIM
;
Dong Jun PARK
Author Information
1. Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea. drpdj@korea.com
- Publication Type:Case Report
- Keywords:
Renal cortical necrosis;
Acute renal failure;
Diclofenac
- MeSH:
Acute Kidney Injury;
Anaphylaxis;
Anemia, Hemolytic;
Biopsy;
Dialysis;
Diclofenac*;
Disseminated Intravascular Coagulation;
Estrogens, Conjugated (USP);
Fibrin;
Humans;
Kidney Cortex Necrosis*;
Middle Aged;
Necrosis;
Renal Dialysis;
Thrombocytopenia;
Tomography, X-Ray Computed
- From:Korean Journal of Nephrology
2006;25(2):317-320
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute bilateral renal cortical necrosis is relatively unusual cause of acute renal failure (ARF). We report a rare case of acute bilateral renal cortical necrosis associated with diclofenac sodium. A 57-year-old man visited to our hospital with progressive oligoanuria for three days. Four days earlier, after diclofenac sodium 150 mg was injected intramuscularly at local hospital, he experienced anaphylactic shock. Our laboratory findings revealed the existence of fibrin split, thrombocytopenia, coagulopathy, and microangiopathic hemolytic anemia (MAHA). These findings were compatible with disseminated intravascular coagulation (DIC). The radiocontrast enhancement CT scan showed a bilateral lack of enhancement of the renal cortex after contrast infusion, enhancement of renal medulla, and the absence of renal excretion of the contrast dye. Renal biopsy showed a cortical necrosis with congested acellular glomuruli and necrotic tubules. Empiric treatment including hemodialysis was commenced. Although his renal function was not completely recovered, he is now being followed up at this hospital without dialysis.
