Acute Renal Failure with Severe Loin Pain and Patchy Renal Vasoconstriction in a Patient without Hypouricemia, Provoked by Epileptic Seizure

Intern Med. 2017;56(15):2001-2005. doi: 10.2169/internalmedicine.56.8328. Epub 2017 Aug 1.

Abstract

A 26-year-old Japanese man without hypouricemia and with 3 previous episodes of seizures concurrent with acute kidney injury (AKI) was admitted due to an epileptic seizure, lower back pain and AKI. His creatinine kinase levels were slightly elevated. Patchy renal ischemia on contrast-enhanced computed tomography and persistent residual contrast medium was observed, consistent with acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE). Diffusion-weighted imaging (DWI) demonstrated signal changes in the corresponding area. ALPE should be considered a cause of AKI following seizures. We recommend DWI as an alternative diagnostic modality.

Keywords: acute kidney injury (AKI); acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE); diffusion-weighted imaging (DWI); patchy renal ischemia; persistent nephrogram; seizure.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / diagnostic imaging
  • Acute Kidney Injury / etiology*
  • Adult
  • Diffusion Magnetic Resonance Imaging
  • Epilepsy / complications*
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology
  • Kidney / blood supply
  • Kidney / diagnostic imaging
  • Low Back Pain / etiology
  • Male
  • Tomography, X-Ray Computed
  • Vasoconstriction