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Case Reports in Nephrology
Volume 2012 (2012), Article ID 510179, 3 pages
http://dx.doi.org/10.1155/2012/510179
Case Report

Acute Renal Failure Secondary to Tuberculosis: A Diagnostic Challenge

1Department of Nephrology, Beaumont Hospital, Dublin 9, Ireland
2Department of Renal Pathology, Beaumont Hospital, Dublin 9, Ireland

Received 26 December 2011; Accepted 30 January 2012

Academic Editors: A. Losito and P. S. Passadakis

Copyright © 2012 Saeed I. Khilji et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tuberculosis is a multiorgan disease with varied clinical presentations and is reemerging due to increasing immigration and globalization. We present the case of an immigrant female patient who developed acute renal failure with clinical and biochemical features suggestive of lupus nephritis but with a timely renal biopsy showing caseating granulomata in the renal parenchyma consistent with renal tuberculosis. Despite treatment with antituberculosis treatment and resolution of TB on repeat renal biopsy, she remained haemodialysis dependent. We discuss the diagnostic challenges faced in this presentation and also explore possible differential diagnoses. This rare presentation highlights the importance of renal biopsy in the diagnosis and treatment of acute renal failure and the atypical presentation of tuberculosis.