Yadla Manjusha

Fatal poisoning by isoniazid and rifampicin

Isoniazid and rifampicin are used for management of tuberculosis. Acute poisoning due to isoniazid overdose is associated with repetitive generalized tonic-clonic seizures and severe metabolic acidosis. In toxic doses, rifampicin is known to produce hepatic, renal, hematological disorders, and convulsions. Sometimes, it may produce red man syndrome. We report a case of fatal poisoning with isoniazid and rifampicin. The case was characterized by late presentation, lactic acidosis, and renal failure.

Chloroform poisoning--a case report.

Chloroform, a halogenated hydrocarbon, causes central nervous system (CNS) depression, cardiac arrhythmias, hepatotoxicity, and renal failure. We describe a successful outcome in a case of chloroform ingestion with renal and hepatotoxicity with N-acetylcysteine (NAC) administration and hemodialysis support.

Distal renal tubular acidosis with nerve deafness secondary to ATP6B1 gene mutation.

Autosomal recessive distal renal tubular acidosis (dRTA) is associated with mutation in the ATP6B1 gene encoding the B1 subunit of H + -ATPase, one of the key membrane transporters for net acid excretion of α-intercalated cells of medullary collecting ducts. Sensori-neural deafness frequently accompanies this type of dRTA. We herewith describe a patient who had distinct features of dRTA with bilateral sensori-neural hearing loss and ATP6B1 mutation. This is a rare entity.

Acute Kidney Injury in Patients with Pyogenic Liver Abscess

Abstract Incidence of acute kidney injury (AKI) in patients with pyogenic liver abscess is rare. In our study we found AKI in 32.6% of patients with liver abscess. Majority of the patients were in their fifties and sixties. As per acute kidney injury network trial criteria, renal failure was in stage 1 in 26.6%, stage 2 in 40%, and stage 3 in 33.3% of the patients. Dialysis support was needed in 26%. All patients except one recovered from AKI.

Hair Dye Related Acute Kidney Injury - A Clinical and Experimental Study

We studied paraphenylenediamine (PPD)-related acute kidney injury (AKI) in 81 patients and also in albino rats experimentally. In the patients’ group AKI was found in 32.7%. Of them, 81.4% needed dialysis support. The overall mortality was 25.9%. In experimental rats the renal lesions were noted in all and they were glomerular congestion, intertubular (interstitial) hemorrhages, acute tubular necrosis, mesangial proliferation, and intratubular casts. The severity of renal injury appears to be dose dependent.

Acute Kidney Injury Due to Emphysematous Pyelonephritis on a Horseshoe Kidney

Emphysematous pyelonephritis (EPN) in association with horseshoe kidney is a rare observation. The review of literature revealed only a single report of this nature.1 Keeping this in view, we describe a diabetic patient who was found to have EPN in horseshoe kidney. Horseshoe kidney is a renal fusion anomaly with male predominance and prevalence being 1 in 400 births. In this anomaly the kidneys are connected by a parenchymatous or fibrous isthmus that crosses the midline. Embryologically the abnormality originates between the fourth and sixth weeks of gestation when the inferior portion of the metanephric blastema fuses before the ascent and rotation of the kidneys. The isthmus of the fused tissue encroaches on the inferior mesenteric artery, preventing further migration of the kidneys. In imaging the features of horseshoe kidney include caudal renal position, malrotation with reversed longitudinal axis of each kidney, and anterior extra renal pelvis. Horseshoe kidney is associated with an increased rate of infection, obstruction, stone formation, and renal tumors.2

Spontaneous Cure of Migrated Peritoneal Catheter

“Catheter migration” refers to displacement of the peritoneal dialysis (PD) catheter from the pelvis to the upper abdomen; migration typically results in PD failure and may require catheter removal (1). Currently, the common management technique is to reposition the catheter—either manually, by laparoscopy, by using a Fogarty balloon catheter, or by a surgical procedure. Spontaneous cure of a migrated catheter is rare. We report one such observation in a patient with diabetic end-stage renal disease on PD.

Gall Stone Ileus with Acute Kidney Injury—A Case Report

Abstract Gall stone ileus is a rare serious complication of cholelithiasis. We report a case of cholecystoduodenal fistula presenting as gall stone ileus with acute kidney injury which was managed successfully.