A Case of Acute Renal Failure Caused by Amphetamine-Associated Rhabdomyolysis / 대한신장학회잡지

Amphetamine toxicity is well known in western countries since several decades ago. Taken in excessive amount, amphetamine causes systemic symptoms such as hyperpyrexia, tachycardia, hyperkinesia, delirium, seizure and circulatory collapse. Acute renal failure following amphetamine ingestion is caused by the direct toxicity of the drug, circulatory collapse, coagulopathy, retroperitoneal hematoma or tubular obstruction by rhabdomyolysis. This is a case of a amphetamine intoxicated 41-year male patient presenting with features of acute renal failure, which is not accompanied by circulatory collapse, nor by coagulopathy. Muscle enzymes and bone scan findings were compatible with nontraumatic muscle injuries, and the renal pathology was tubular necrosis with specific myoglobin casts. Therefore a drug induced rhabdomyolysis causing myoglobinuric tubular injury is highly suspected. The fact that the outcome of the renal disease itself was good despite fatal dosage of this drug is also compatible with myoglobinuric renal failures reported by foreign authors. This is probably the first reported case of acute renal failure caused by amphetamine associated rhabdomyolysis in Korea.

A Case of Acute Renal Failure and Other Symptoms Associated with Phytolacca Radix Poisoning / 대한신장학회잡지

Phytolaccae had been used as a pharmaceutical drug or food But nowadays, due to its toxicity, Phytolaccae is rarely used and cases of patients poisoned with it are seldom reported. The case presented here was of 43 year-old male who after ingesting extract of Phytolacca esculenta suffered from abdominal pain, diarrhea, nausea, vomiting, tachycardia, hypotension, pruritus, paresthesia, oliguria and azotemia. Kidney biopsy revealed tubular necrosis and some protein casts in tubular lumens. These findings suggested that acute renal failure was mainly caused by nephrotoxicity of Phytolacca extracts. Through continuous arteriovenous hemofiltration and two times of hemodialysis, he was completely recovered from acute renal failure. Other symptoms also disappeared by symptomatic management, but paresthesia of both lower extremities still remained. So we reported this case with a brief review of literature.