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Bile cast nephropathy after liver transplantation

Rafaela Novak ; School of Medicine University of Zagreb
Anna Mrzljak ; Department of Gastroenterology, University Hospital Merkur Zagreb

Puni tekst: engleski, pdf (106 KB) str. 0-0 preuzimanja: 7* citiraj
APA 6th Edition
Novak, R. i Mrzljak, A. (2019). Bile cast nephropathy after liver transplantation. Liječnički vjesnik, 141 (suppl.1), 0-0. Preuzeto s https://hrcak.srce.hr/225337
MLA 8th Edition
Novak, Rafaela i Anna Mrzljak. "Bile cast nephropathy after liver transplantation." Liječnički vjesnik, vol. 141, br. suppl.1, 2019, str. 0-0. https://hrcak.srce.hr/225337. Citirano 06.12.2019.
Chicago 17th Edition
Novak, Rafaela i Anna Mrzljak. "Bile cast nephropathy after liver transplantation." Liječnički vjesnik 141, br. suppl.1 (2019): 0-0. https://hrcak.srce.hr/225337
Harvard
Novak, R., i Mrzljak, A. (2019). 'Bile cast nephropathy after liver transplantation', Liječnički vjesnik, 141(suppl.1), str. 0-0. Preuzeto s: https://hrcak.srce.hr/225337 (Datum pristupa: 06.12.2019.)
Vancouver
Novak R, Mrzljak A. Bile cast nephropathy after liver transplantation. Liječnički vjesnik [Internet]. 2019 [pristupljeno 06.12.2019.];141(suppl.1):0-0. Dostupno na: https://hrcak.srce.hr/225337
IEEE
R. Novak i A. Mrzljak, "Bile cast nephropathy after liver transplantation", Liječnički vjesnik, vol.141, br. suppl.1, str. 0-0, 2019. [Online]. Dostupno na: https://hrcak.srce.hr/225337. [Citirano: 06.12.2019.]

Sažetak
Bile cast nephropathy is a rare condition of renal dysfunction related to hyperbilirubinemia. The kidney injury is generally reversible if bilirubin levels are decreased early. Pathohistological findings are a result of bile casts formation and direct bile acids toxicity on renal tissue. Herein, we present a case of bile cast nephropathy after liver transplantation. A 60-year old male underwent liver transplantation (LT) in 2016 due to cryptogenic cirrhosis. Seven months after LT his liver function unexpectedly deteriorated and he developed severe jaundice (bilirubin=415 μmol/L) accompanied by acute renal failure (creatinine= 190μmol/L). A liver biopsy revealed an acute injury of unidentified aetiology, while the renal findings indicated bile cast nephropathy with nephroangiosclerosis and fibrosis. The treatment included plasmapheresis which resulted in partial recovery of renal and liver function. However, in proceeding weeks patient’s liver function deteriorated (bilirubin=501 μmol/L; AST=267IU/L; ALT=503IU/L), and due to unidentified liver failure, the patient was retransplanted. His renal function partially improved with resolving hyperbilirubinemia following LT (creatinine=145μmol/L). He was discharged from the hospital with normally functioning graft and improved but still impaired kidney function. There are only a few reported cases of this condition described in the literature and aetiology of this condition is still not completely understood. The presented case report demonstrates the particular background of bile cast nephropathy and the subsequent treatment. Though, we emphasize the need for further investigations of this condition, as well as the established treatment guidelines.

Ključne riječi
bile cast nephropathy, liver transplantation, renal failure, hyperbilirubinemia

Hrčak ID: 225337

URI
https://hrcak.srce.hr/225337

Posjeta: 13 *