Exanthema and acute anuric renal failure.
A 15-year-old girl with a history of Kawasaki disease was admitted to our nephrological department due to acute renal failure. Despite antibiotic therapy because of fever and the symptoms of a pharyngitis in the last few days, the girl showed persisting fever and developed arthralgias, an exanthema and a rising serum creatinine as well as anuria. A wide variety of differential diagnoses has to be thought of because of the history of the Kawasaki disease (symptoms like fever, pharyngitis, exanthema and arthralgia), i.e. hemolytic-uremic syndrome, vasculitis, ascending infection, postinfection glomerulonephritis. In consideration of etiologically unclear "rapidly progressive renal failure" with anuria and thrombocytopenia an immediate renal biopsy was done and revealed a severe drug induced acute interstitial nephritis. Due to this diagnosis we treated the patient with corticosteroids. Within 4 weeks serum creatinine declined to 1.8 mg/dl but did not normalize.
Resch
M
M
Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Germany.
Banas
B
B
Endemann
D
D
Mack
M
M
Riegger
G A J
GA
Gröne
H J
HJ
Krämer
B K
BK
D058186:Acute Kidney Injury / Q000150:complications* / Q000209:etiology; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001002:Anuria / Q000150:complications / Q000209:etiology; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005076:Exanthema / Q000150:complications* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications; D009395:Nephritis, Interstitial / Q000150:complications / Q000175:diagnosis / Q000209:etiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D003404:Creatinine