Open Access 01-02-2024 | Interstitial Nephritis | Lessons for the Clinical Nephrologist
A case of acute interstitial nephritis superimposed on rhabdomyolysis in a refugee patient
Published in: Journal of Nephrology
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A 46-year-old male patient of Syrian origin, who has temporary protection status in Turkey, was brought to our Emergency Department with superficial wounds all over his body. He had nausea, malaise, swollen extremities and muscle weakness. He was tachypneic at rest. His blood pressure was 155/90 mmHg. Laboratory work-up showed a serum creatinine level of 10.69 mg/dL and he had hyperkalemia (6.11 mmol/L). He had a creatine kinase level of 14,117 U/L and high transaminases. As he also had acidosis with a bicarbonate level of 14 mmol/L and oliguria (150 cc in the previous 6 h), urgent hemodialysis was prescribed. He was then admitted to our nephrology ward. Other laboratory values on admission can be found in Table 1.
Table 1
Laboratory values at admission
|
Urea (mg/dL)
|
204.2
|
|
Creatinine (mg/dL)
|
10.69
|
|
Sodium (mmol/L)
|
138
|
|
Potassium (mmol/L)
|
6.11
|
|
Calcium (mg/dL)
|
7.9
|
|
Phosphorus (mg/dL)
|
7.49
|
|
Albumin (g/dL)
|
2.98
|
|
Magnesium (mg/dL)
|
2.08
|
|
Alanine aminotransferase (ALT) (U/L)
|
277
|
|
Aspartate aminotransferas (AST) (U/L)
|
394
|
|
Uric acid (mg/dL)
|
4.7
|
|
C-Reactive Protein (mg/L)
|
40.76
|
|
Creatine Kinase (U/L)
|
14,117
|
|
Lactate dehydrogenase (U/L)
|
997
|
|
Total bilirubin (mg/dL)
|
0.7
|
|
Direct bilirubin (mg/dL)
|
0.25
|
|
Hemoglobin (g/dL)
|
10.8
|
|
Platelet (*103/μL)
|
169
|