A Patient with Acute Kidney Injury Associated with Massive Proteinuria and Acute Hyperuricemia after Epileptic Seizures

Intern Med. 2022 Nov 15;61(22):3401-3408. doi: 10.2169/internalmedicine.8808-21. Epub 2022 Apr 23.

Abstract

A 25-year-old man presented with acute kidney injury (AKI), massive proteinuria and hyperuricemia after epileptic seizures. His AKI improved along with the disappearance of proteinuria after corticosteroid treatment. A kidney biopsy revealed no significant glomerular abnormalities, but varying degrees of tubular injury, such as proximal tubular simplification, mild distal tubular proliferation, and Tamm-Horsfall protein-like material accumulation with extravasation into the interstitium, were noted. A further analysis revealed the intratubular depositions of uric acid crystals, indicating the involvement of acute uric acid nephropathy associated with seizures. Our patient's condition is rare, and the clinicopathological aspects of the diagnostic challenges are discussed.

Keywords: acute kidney injury; minimal change nephrotic syndrome; seizure; uric acid nephropathy.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Adult
  • Epilepsy* / complications
  • Epilepsy* / drug therapy
  • Humans
  • Hyperuricemia* / complications
  • Kidney / pathology
  • Male
  • Proteinuria / etiology
  • Seizures / etiology
  • Uric Acid

Substances

  • Uric Acid