title: Renal cortical necrosis complicating laundry detergent ingestion.
abstract: Accidental oral detergent ingestion usually causes mild gastrointestinal manifestations including nausea, vomiting and diarrhea as well as upper airway irritation. There are a limited number of reported oral detergent ingestions leading to acute kidney injury, mainly due to rhabdomyolysis. We present an ultimately fatal case of laundry detergent ingestion leading to biopsy proven severe cortical necrosis and irreversible renal damage. Detergent ingestion was associated with widespread endothelial injury leading to a picture of thrombotic microangiopathy. Among the detergent ingredients ingested by the patient, sodium borate raised the highest concern as a potential toxin exacerbated further by severe hypovolaemia and consequent decrease in renal toxin excretion. As sodium borate is dialyzable, haemodialysis should be a consideration early after laundry detergent ingestion.
authors.affiliation: Renal Division.
authors.forename: Leonardo Vidal
authors.initials: LV
authors.lastname: Riella
authors.affiliation: Department of Medicine, MetroWest Medical Center.
authors.forename: Sunitha
authors.initials: S
authors.lastname: Golla
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy, Targu Mures, Romania.
authors.forename: Grigore
authors.initials: G
authors.lastname: Dogaru
authors.affiliation: Renal Division.
authors.forename: Helmut G
authors.initials: HG
authors.lastname: Rennke
authors.affiliation: Pathology Division , Brigham and Women's Hospital, Boston, MA , USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Christopher
keywords: acute kidney injury; cortical necrosis; detergent