Articles: myoglobinuria-complications.
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Case Reports
Acute renal failure from myoglobinuria secondary to myositis from severe falciparum malaria.
Renal disease is a common complication in malaria infection. In acute falciparum malaria renal involvement is usually mild, but in severe disease acute renal failure is a major problem. Acute renal failure has been attributed to ischaemic tubular necrosis from hypovolaemia resulting from vasodilatation due to endothelial injury. ⋯ The kidney biopsy showed scanty T cells and macrophages in the glomeruli which were only mildly hypercellular. The renal tubules showed myoglobin casts in the lumen and foci of interstitial inflammatory cells, including macrophages and T lymphocytes but no CD4+ cells. Rhabdomyolysis induced by macrophages and T cells with myoglobinuria and acute renal failure is a problem in severe falciparum malaria infection.
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Intensive care medicine · Oct 1999
Case ReportsMyoglobin clearance and removal during continuous venovenous hemofiltration.
Myoglobin has a relatively high molecular weight of 17,000 Da and is poorly cleared by dialysis (diffusion). However, elimination of myoglobin might be enhanced by an epuration modality based on convection for solute clearances. We present a single case of myoglobin-induced renal failure (peak creatine kinase level: 313,500 IU/l) treated by continuous venovenous hemofiltration (CVVH). ⋯ If myoglobin clearance had been maintained at 22 ml/min, 32 l of serum would have been cleared per day. However, the sieving coefficient of myoglobin decreased over time, probably as a consequence of protein coating and/or blood clotting of the hemofilter. Whereas myoglobin can be removed by CVVH, it remains unknown at this point if such a modality, applied early, can alter or shorten the course of myoglobinuric acute renal failure.
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Case Reports
Severe hyponatremia, neuroleptic malignant syndrome, rhabdomyolysis and acute renal failure: a case report.
Acute renal failure secondary to myoglobinuria is a rare yet possible complication of malignant neuroleptic syndrome associated with the use of dopamine antagonists. We describe the case of a 42-year-old schizophrenic man who presented with severe hyponatremia, and proceeded to acute malignant neuroleptic syndrome, rhabdomyolysis, and acute renal failure. We contend that the acute hyponatremia may have served as a precipitating factor.