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International Journal of Nephrology
Volume 2011, Article ID 679160, 5 pages
http://dx.doi.org/10.4061/2011/679160
Case Report

Acute Renal Failure, Microangiopathic Haemolytic Anemia, and Secondary Oxalosis in a Young Female Patient

1Clinical Pathology Department, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK
2Department of Histopathology, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK
3Renal Unit, Nottingham University Hospitals Trust, Nottingham NG5 1PB, UK

Received 8 February 2011; Revised 12 April 2011; Accepted 6 May 2011

Academic Editor: David B. Kershaw

Copyright © 2011 Karolina M. Stepien 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

A 29-year old female presented with a one-week history of vomiting, diarrhoea, abdominal pain, and headache. On admission, she had acute renal failure requiring dialysis. Tests revealed a hemolytic anemia with thrombocytopenia. An initial diagnosis of thrombotic thrombocytopenic microangiopathy was made and plasma exchange was instigated. However, renal biopsy did not show thrombotic microangiopathy but instead revealed acute kidney injury with mild tubulointerstitial nephritis and numerous oxalate crystals, predominantly in the distal tubules. The patient had been taking large doses (>1100 mg daily) of vitamin C for many months. She also gave a history of sclerotherapy using injections of an ethylene glycol derivative for superficial leg veins. The patient completed five sessions of plasma exchange and was able to discontinue dialysis. She eventually achieved full renal recovery. She has now discontinued sclerotherapy and vitamin supplementation.