FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4387248717> ?p ?o ?g. }

• W4387248717 endingPage "A2157" @default.
• W4387248717 startingPage "A2156" @default.
• W4387248717 abstract "SESSION TITLE: Critical Care Case Report Posters 50 SESSION TYPE: Case Report Posters PRESENTED ON: 10/10/2023 09:40 am - 10:25 am INTRODUCTION: Intravascular hemolysis is a rare cause of anemia in the intensive care unit. This occurs due to erythrocyte destruction, and can lead to acute kidney injury from the breakdown of hemoglobin into its nephrotoxic components.1 Intravascular hemolysis is not only uncommon, but it can mimic other causes of acute kidney injury, which can make its diagnosis challenging, as in this case. CASE PRESENTATION: The subject of this case is a 75 year old female with a history of Mycobacterium avium lung infection and Raynaud's disease. She was admitted to the ICU with concerns for thrombotic thrombocytopenic purpura (TTP) after re-initiation of treatment for Mycobacterium avium complex (MAC) infection. She has a history of MAC in 2017 treated for fourteen months with three dug therapy including azithromycin, ethambutol, and rifampin. In July 2022, sputum cultures revealed active infection, and therapy was restarted. In August, she developed a three day history of lightheadedness, fatigue, rigors, nausea, and back pain. Outpatient labs revealed platelets 59 K/uL, lactate dehydrogenase (LDH) 2540 U/L, creatinine 4.7 mg/dl, and d-dimer 69,000 ng/ml. MAC therapy was discontinued.On admission to the ICU, she was afebrile and hemodynamically stable, but she acutely developed altered mental status, lethargy, and anuria. Given this, she received emergent plasmapheresis. Labs illustrated hemoglobin of 10.5 g/dL with occasional schistocytes, WBC 25 K/uL, platelets 57 K/uL, creatinine 5.5 mg/dl, BUN 65 mg/dL, LDH 1401 U/L, haptoglobin 34 mg/dL, and d-dimer 49,597 ng/ml. CT brain, MRI, and EEG were unremarkable. She was ultimately started on methylprednisolone and emergent hemodialysis plus daily plasmapheresis.Rheumatologic and infectious work up was unremarkable, and ADAMTS13 eventually came back as normal. Kidney biopsy ultimately illustrated a diagnosis of hemoglobin cast nephropathy. After improvement, she was discharged on a prednisone taper with continued hemodialysis, and rifampin was discontinued. DISCUSSION: Hemoglobin cast nephropathy in this patient was attributed to drug-induced intravascular hemolysis secondary to rifampin as a part of MAC therapy. This is despite previously tolerating rifampin, as described in a similar case by Mahmud et al. as well.2 In a case series by Dvanajsack et al., of the 26% of patients with medication induced hemoglobin cast nephropathy, 57% were caused by rifampin. There was 78% recovery in kidney function after prompt diagnosis with kidney biopsy and treatment, as seen here.1 MAC treatment usually involves the use of three drug therapies to reduce the risk of dissemination and macrolide resistance. However, according to Miwa et al., treatment with ethambutol and a macrolide, like clarithromycin, is not inferior to standard three drug treatment.3 Further research on two drug regimens will be valuable to guide treatment options, especially for those with rifampin intolerance. CONCLUSIONS: It is imperative that physicians maintain a high suspicion for hemoglobin cast nephropathy specifically in patients with hemolysis and acute kidney injury for prompt diagnosis and removal of the instigating factor. This is especially pertinent in the setting of rifampin use. REFERENCE #1: Dvanajscak Z., Walker P.D., Cossey L.N. Hemolysis-associated hemoglobin cast nephropathy results from a range of clinicopathologic disorders. Kidney Int. 2019;96:1400–1407. doi: 10.1016/j.kint.2019.08.026 REFERENCE #2: Mahmud S., Dernell C., Bal N., Gallan A.J., Blumenthal S., Koratala A., Sturgill D. Hemoglobin cast nephropathy. Kidney Int Rep. 2020 Jun 29;5(9):1581-1585. doi: 10.1016/j.ekir.2020.06.019 REFERENCE #3: Miwa S, Shirai M, Toyoshima M, et al. Efficacy of clarithromycin and ethambutol for Mycobacterium avium complex pulmonary disease. A preliminary study. Ann Am Thorac Soc. 2014;11(1):23-29. doi:10.1513/AnnalsATS.201308-266OC DISCLOSURES: No relevant relationships by Prashant Grover No relevant relationships by Sankar Niranjan No relevant relationships by Alexandria Plant No relevant relationships by Moe Uddin" @default.
• W4387248717 created "2023-10-03" @default.
• W4387248717 creator A5008070476 @default.
• W4387248717 creator A5029275475 @default.
• W4387248717 creator A5078352231 @default.
• W4387248717 creator A5089152524 @default.
• W4387248717 date "2023-10-01" @default.
• W4387248717 modified "2023-10-03" @default.
• W4387248717 title "THE GREAT MASQUERADE: CRITICAL HEMOGLOBIN CAST NEPHROPATHY SECONDARY TO RIFAMPIN FOR THE TREATMENT OF MYCOBACTERIUM AVIUM COMPLEX LUNG DISEASE" @default.
• W4387248717 doi "https://doi.org/10.1016/j.chest.2023.07.1465" @default.
• W4387248717 hasPublicationYear "2023" @default.
• W4387248717 type Work @default.
• W4387248717 citedByCount "0" @default.
• W4387248717 crossrefType "journal-article" @default.
• W4387248717 hasAuthorship W4387248717A5008070476 @default.
• W4387248717 hasAuthorship W4387248717A5029275475 @default.
• W4387248717 hasAuthorship W4387248717A5078352231 @default.
• W4387248717 hasAuthorship W4387248717A5089152524 @default.
• W4387248717 hasBestOaLocation W43872487171 @default.
• W4387248717 hasConcept C126322002 @default.
• W4387248717 hasConcept C141071460 @default.
• W4387248717 hasConcept C142724271 @default.
• W4387248717 hasConcept C2776228421 @default.
• W4387248717 hasConcept C2776422910 @default.
• W4387248717 hasConcept C2777975735 @default.
• W4387248717 hasConcept C2778585876 @default.
• W4387248717 hasConcept C2778594517 @default.
• W4387248717 hasConcept C2780472472 @default.
• W4387248717 hasConcept C2781069245 @default.
• W4387248717 hasConcept C2781127562 @default.
• W4387248717 hasConcept C65245452 @default.
• W4387248717 hasConcept C71924100 @default.
• W4387248717 hasConcept C89560881 @default.
• W4387248717 hasConcept C90924648 @default.
• W4387248717 hasConceptScore W4387248717C126322002 @default.
• W4387248717 hasConceptScore W4387248717C141071460 @default.
• W4387248717 hasConceptScore W4387248717C142724271 @default.
• W4387248717 hasConceptScore W4387248717C2776228421 @default.
• W4387248717 hasConceptScore W4387248717C2776422910 @default.
• W4387248717 hasConceptScore W4387248717C2777975735 @default.
• W4387248717 hasConceptScore W4387248717C2778585876 @default.
• W4387248717 hasConceptScore W4387248717C2778594517 @default.
• W4387248717 hasConceptScore W4387248717C2780472472 @default.
• W4387248717 hasConceptScore W4387248717C2781069245 @default.
• W4387248717 hasConceptScore W4387248717C2781127562 @default.
• W4387248717 hasConceptScore W4387248717C65245452 @default.
• W4387248717 hasConceptScore W4387248717C71924100 @default.
• W4387248717 hasConceptScore W4387248717C89560881 @default.
• W4387248717 hasConceptScore W4387248717C90924648 @default.
• W4387248717 hasIssue "4" @default.
• W4387248717 hasLocation W43872487171 @default.
• W4387248717 hasOpenAccess W4387248717 @default.
• W4387248717 hasPrimaryLocation W43872487171 @default.
• W4387248717 hasRelatedWork W1502347726 @default.
• W4387248717 hasRelatedWork W2013579526 @default.
• W4387248717 hasRelatedWork W2016125023 @default.
• W4387248717 hasRelatedWork W2382308484 @default.
• W4387248717 hasRelatedWork W2396873143 @default.
• W4387248717 hasRelatedWork W2407798827 @default.
• W4387248717 hasRelatedWork W2460526823 @default.
• W4387248717 hasRelatedWork W2801172522 @default.
• W4387248717 hasRelatedWork W3042475035 @default.
• W4387248717 hasRelatedWork W4231154844 @default.
• W4387248717 hasVolume "164" @default.
• W4387248717 isParatext "false" @default.
• W4387248717 isRetracted "false" @default.
• W4387248717 workType "article" @default.