title: Exercise-induced acute kidney injury with reversible posterior leukoencephalopathy syndrome.
abstract: We report a case of a 17-year-old boy suffering from severe loin pain and oliguric acute kidney injury after strenuous exercise, with slightly elevated serum myoglobin and creatinine phosphokinase. Exercise-induced acute kidney injury (AKI) was diagnosed. We started intermittent hemodialysis thrice a week from the admission day. Four days later, he temporally lost consciousness, followed by visual agnosia and general clonic seizure. T2-weighted brain magnetic resonance images (MRI) showed multiple areas of increased signal intensity in the subcortical white matter, predominantly in the cerebrum of the posterior and parietal lobes and in the cerebellum. Clinical symptoms improved without sequelae. Follow-up MRI 1 month later showed complete resolution of the signals, and he was diagnosed with reversible posterior leukoencephalopathy syndrome (RPLS). This is the first reported case of exercise-induced AKI associated with RPLS. Vasoconstriction and endothelial dysfunction are considered as the common etiology of these diseases.
authors.affiliation: Department of Geriatric Medicine and Nephrology, Osaka University School of Medicine, Suita, Osaka 585-0871, Japan. t-kimura@kid.med.osaka-u.ac.jp
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kimura
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Iio
authors.forename: Enyu
authors.initials: E
authors.lastname: Imai
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Isaka
authors.forename: Terumasa
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000293:Adolescent; D015444:Exercise; D006801:Humans; D007668:Kidney / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000209:etiology; D054038:Posterior Leukoencephalopathy Syndrome / Q000209:etiology*; D006435:Renal Dialysis; D014527:Uric Acid
chemical_list: D014527:Uric Acid