acute renal failure, microangiopathic haemolytic anemia, and secondary oxalosis in a young female patient急性肾功能衰竭、microangiopathic溶血性贫血和二级oxalosis年轻的女病人.pdfVIP

SAGE-Hindawi Access to Research International Journal of Nephrology Volume 2011, Article ID 679160, 5 pages doi:10.4061/2011/679160 Case Report Acute Renal Failure, Microangiopathic Haemolytic Anemia, and Secondary Oxalosis in a Young Female Patient Karolina M. Stepien,1 Peter Prinsloo,1 Tony Hitch,1 Thomas A. McCulloch,2 and Rebecca Sims3 1 Clinical Pathology Department, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK 2 Department of Histopathology, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK 3 Renal Unit, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK Correspondence should be addressed to Karolina M. Stepien, kstepien@.uk Received 8 February 2011; Revised 12 April 2011; Accepted 6 May 2011 Academic Editor: David B. Kershaw Copyright © 2011 Karolina M. Stepien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A 29-year old female presented with a one-week history of vomiting, diarrhoea, abdominal pain, and headache. On admission, she had acute renal failure requiring dialysis. Tests revealed a hemolytic anemia with thrombocytopenia. An initial diagnosis of thrombotic thrombocytopenic microangiopathy was made and plasma exchange was instigated. However, renal biopsy did not show thrombotic microangiopathy but instead revealed acute kidney injury with mild tubulointerstitial nephritis and numerous oxalate crystals, predominantly in the distal tubules. The patient had been taking large doses (1100 mg daily) of vitamin C for many months. She also gave a history of sclerotherapy using injections of an ethylene glycol derivative for superficial leg