Bile Cast Nephropathy Caused by Obstructive Pancreatic Carcinoma and Failed ERCP

Bile cast nephropathy is an often overlooked condition of acute renal injury in the setting of high serum bilirubin. While the exact pathophysiology remains unknown, possible mechanisms of renal injury are tubular obstruction from bile casts, direct toxicity from bile acids, and decreased renal perf...

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Bibliographic Details
Published inACG case reports journal Vol. 5; no. 12; pp. e881 - 3
Main Authors van de Ven, Steffi EM, Pavlov, Kirill V., Beutler, Jaap J., Scheffer, Robbert CH
Format Journal Article
LanguageEnglish
Published American College of Gastroenterology 05.12.2018
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Case Report
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Summary:Bile cast nephropathy is an often overlooked condition of acute renal injury in the setting of high serum bilirubin. While the exact pathophysiology remains unknown, possible mechanisms of renal injury are tubular obstruction from bile casts, direct toxicity from bile acids, and decreased renal perfusion due to hemodynamic changes. We present a patient with hyperbilirubinemia as a result of common bile duct obstruction due to pancreatic adenocarcinoma who developed anuric acute renal injury. Urine analysis showed bile casts that were highly suggestive for bile cast nephropathy. The patient underwent hemodialysis and bile drainage with full restoration of renal function.
ISSN:2326-3253
2326-3253
DOI:10.14309/crj.2018.88