poppy
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Babesiosis-Induced Acute Kidney Injury With Prominent Urinary Macrophages.
Authors: Luciano RL, Moeckel G, Palmer M, Perazella MA
Citation: Am. J. Kidney Dis. 2013(May)
Location: Section of Nephrology, Yale University School of Medicine, New Haven, CT.
DOI: 10.1053/j.ajkd.2013.02.376
Babesia is an obligate intracellular erythrocyte parasite that can infect humans. Severe symptomatic disease from massive hemolysis and multiorgan system failure, including acute kidney injury (AKI), occurs. Acute tubular injury from a combination of volume depletion and heme pigment toxicity from profound hemolysis is the most common cause of AKI.
We present a case of severe babesiosis complicated by dialysis-requiring AKI with the unique finding of large macrophages containing engulfed erythrocyte fragments in urine sediment. This urinary finding raised the possibility of another diagnosis distinct from acute tubular injury. Subsequent kidney biopsy demonstrated infection-associated acute interstitial nephritis.
Copyright � 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. 10.1053/j.ajkd.2013.02.376
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