A successfully treated case of acute renal failure due to acute immune hemolytic anemia and nontraumatic rhabdomyolysis induced by streptomycin reinjection

• Published in: Nihon Jinzo Gakkai shi Vol. 34; no. 11; pp. 1233 - 1236
• Main Authors: NAKAHARA, YOSHIFUMI, KATOH, SHUJI, YAMADA, HIROYUKI, KANETAKE, YASUFUMI, TERASHIMA, SATOSHI, TATSUKAWA, HIROTAKA, IDA, KAZUNORI, SHIMAZAKI, CHIHIRO, NAKAGAWA, MASAO
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01.11.1992
• Subjects: Acute Disease; Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Aged; Anemia, Hemolytic, Autoimmune - chemically induced; Anemia, Hemolytic, Autoimmune - complications; Female; Humans; Renal Dialysis; Rhabdomyolysis - chemically induced; Rhabdomyolysis - complications; Streptomycin - adverse effects; streptomycin, hemolytic anemia, non-traumatic rhabdomyolysis, hemodialysis
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.34.1233

A case of acute immune hemolytic anemia associated with non-traumatic rhabdomyolysis (NTR) induced by streptomycin (SM) reinjection, which developed acute renal failure, has been reported. A 70-year-old female was admitted to our hospital because of sudden macroscopic hematuria after reinjection of lg. SM. Laboratory findings on admission were as follows; hemoglobin and myoglobin were positive in urine. RBC 129×104/μl, Hb 4.9g/dl, Ht 11.1%, reticulocytes 52%, serum indirect billirubin 3.8g/dl. LDH 9, 230 WU, BUN 149mg/dl, Cr 7.9mg/dl, myoglobin 1, 400ng/ml and haptoglobin 10.6mg/dl. The drug lymphocyte stimulating test of SM was positive (215%). A direct antiglobulin test was also positive. An indirect antiglobulin test was negative, but became positive after incubation with SM. These observations made the diagnosis of SM-induced hemolytic anemia associated with NTR. On the second hospital day she developed anuria, and was put on hemodialysis treatment. Two months after the acute hemolytic episode and acute renal failure she recovered and is presently in good health without recurrence.