Case Report: Acute renal tubular injury with acute hepatitis A infection: Is it just a coincidence?

• Published in: Nephrology (Carlton, Vic.) Vol. 9; no. 1; pp. 44 - 46
• Main Authors: Shroff, Gautam R, Badve, Sunil V, Joshi, Anand G, Desai, Devendra C, Abraham, Philip, Sirsat, Rasika A
• Format: Journal Article
• Language: English
• Published: 01.02.2004
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/j.1440-1797.2003.00224.x

Acute renal failure has rarely been reported in association with acute hepatitis A infection. The commonest form of renal injury in such patients has been found to be acute tubular necrosis. We report two cases of hepatitis A infection in which acute renal failure occurred very early in the course of the illness and had a clinical presentation and recovery pattern suggestive of acute tubular necrosis. In both patients, the clinical course of renal dysfunction was almost parallel to the course of hepatic dysfunction. Patient 1 needed dialysis, whereas patient 2 did not need dialysis and had a very rapid recovery from renal function in spite of having more severe azotaemia. Patient 2 was administered acetylcysteine in high doses for suspected fulminant hepatic failure. A potential benefit of a high dose of acetylcysteine in recovery of renal function from acute tubular necrosis is postulated.