title: Intratubular hemoglobin casts in hemolysis-associated acute kidney injury.
abstract: Kidney injury is a complication of intravascular hemolysis associated with many forms of hemolytic disease. Reports of kidney biopsy findings in patients with hemolysis-related kidney injury have focused primarily on the accumulation of hemosiderin pigment within proximal tubular epithelial cells (hemosiderosis), a feature of chronic hemolysis. The nephrotoxic effects of hemoglobin include direct cytotoxicity to tubular cells, but hemoglobin also can precipitate in distal nephron segments, forming obstructive casts. We present a case of hemolysis-associated tubular injury, characterized by acute onset of intravascular hemolysis followed by acute kidney injury with acute tubular injury and abundant intratubular casts containing hemoglobin.
authors.affiliation: Department of Pathology, University of Chicago, Chicago, IL. Electronic address: maz.a.khalighi@gmail.com.
authors.forename: Mazdak A
authors.initials: MA
authors.lastname: Khalighi
authors.affiliation: Department of Pathology, University of Chicago, Chicago, IL.
authors.forename: Kammi J
authors.initials: KJ
authors.lastname: Henriksen
authors.affiliation: Department of Pathology, University of Chicago, Chicago, IL.
authors.forename: Anthony
authors.initials: A
authors.lastname: Chang
authors.affiliation: Department of Pathology, University of Chicago, Chicago, IL.
authors.forename: Shane M
authors.initials: SM
authors.lastname: Meehan
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis*; D000328:Adult; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006461:Hemolysis / Q000502:physiology*; D006801:Humans; D007684:Kidney Tubules / Q000378:metabolism* / Q000473:pathology*
chemical_list: D006454:Hemoglobins
keywords: Acute kidney injury (AKI); acute tubular injury; acute tubular necrosis; hemoglobin casts; intravascular hemolysis; renal biopsy