MULTIPLE SCLEROSIS INDUCED RHABDOMYOLYSIS INDUCED ACUTE KIDNEY INJURY.

Back

E-Poster

https://storage.unitedwebnetwork.com/files/1099/93329bf2c99ea49ebcc9e13c48634c9f.pdf

Abstract Title

First Name *

Ahmed

Last Name *

AKL

Co-author 1

Abdelwahab Alqahtani abaalqahtani@fakeeh.care Dr Soliman Fakeeh Hospital Internal Medicine Jeddah

Co-author 2

Arwa Jamal ajamal@fakeeh.care Dr Soliman Fakeeh Hospital Internal Medicine Jeddah

Co-author 3

Faissal Shaheen fashaheen@fakeeh.care Dr Soliman Fakeeh Hospital Adult Nephrology Jeddah

Co-author 4

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

The kidneys can be injured in diverse ways. Demyelinated disease (Multiple sclerosis) can present with severe muscle spasticity. We report a case of acute kidney injury post rhabdomyolysis secondary to severe attack of muscle spasticity secondary to multiple sclerosis.

Methods

A 37-year-old man who was previously healthy. The patient presented to the emergency department with persistent vomiting that began three days ago, localized epigastric abdomen discomfort, no temperature or oedema in the lower limbs, confusion, blurring of vision, generalized fatigability, and limited muscle strength following attacks of severe muscle cramps with muscle stiffness.

Results

Renal ultrasound revealed that both kidneys were normal in size, with grade II hyper-echogenicity, no stones, and no backpressure. Serum creatinine was 10.41 mg/dl, BUN 160 mg/dl, potassium 5.5 mg/dl, calcium 7.3 mg/dl, phosphorus 7.9 mg/dl, PTH 413.9 pg/ml, serum albumin 3.5 g/l, and serum bicarb 16 mmol/l after 24 hours of excellent hydration. ANA 5.4 [N. 20], Anti-cardiolipin normal, C3 1.38 normal, C4 0.47 [N. 0.1-0.4 g/l], Anti-dsDNA 9 [N. 20], and c-ANCA-PR3 4.2, p-ANCA-MPO 1.4 [N. 20] were all normal. High blood uric acid was related with low calcium, high phosphorus, and a total creatine kinase level of 13732 U/L [N. 308 U/l]. Renal biopsy was performed, followed by 3 days of pulse methylprednisolone 1000 mg/day. Renal biopsy revealed myoglobin casts, which were verified by immunostaining and were linked to tubular damage. Oligo-clonal bands were positive in the patient's CSF, indicating demyelinated illness (Multiple Sclerosis). Urine output increased daily until it reached >1000 mL/day, and serum creatinine began to fall gradually to 10.49 mg/dl. Serum creatinine was measured again after two weeks and found to be 1.97 mg/dl. Dimethyl fumarate was prescribed to the patient for multiple sclerosis. After three months, serum creatinine was normal at 1.07 mg/dl, BUN was normal at 9 mg/dl, and electrolytes were normal. During the last two years of regular follow-up, the patient's kidney function remained normal.

Conclusions

We present a case of severe acute renal injury linked with rhabdomyolysis caused by severe multiple sclerosis, with a favorable prognosis.

E-Poster Format Requirements

PDF file
Layout: Portrait (vertical orientation)
One page only (Dim A4: 210 x 297mm or PPT)
E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
File Size: Maximum file size is 2 Megabytes (2 MB)
No hyperlinks, animated images, animations, and slide transitions
Language: English
Include your abstract number
E-posters can include QR codes, tables and photos