A Patient with Acute Kidney Injury Associated with Massive Proteinuria and Acute Hyperuricemia after Epileptic Seizures

Yoshihiro Tomomitsu; Shinichiro Asakawa; Shigeyuki Arai; Michito Nagura; Kenichi Ishizawa; Osamu Yamazaki; Yoshifuru Tamura; Shunya Uchida; Ryuji Ohashi; Shigeru Shibata; Yoshihide Fujigaki

doi:10.2169/internalmedicine.8808-21

This article has now been updated. Please use the final version.

A Patient with Acute Kidney Injury Associated with Massive Proteinuria and Acute Hyperuricemia after Epileptic Seizures

Yoshihiro Tomomitsu, Shinichiro Asakawa, Shigeyuki Arai, Michito Nagura, Kenichi Ishizawa, Osamu Yamazaki, Yoshifuru Tamura, Shunya Uchida, Ryuji Ohashi, Shigeru Shibata, Yoshihide Fujigaki

Author information

Keywords: acute kidney injury, minimal change nephrotic syndrome, seizure, uric acid nephropathy

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8808-21

DOI https://doi.org/10.2169/internalmedicine.8808-21

The final version of this article is now available: Vol. 61 (2022), No. 22 pp. 3401-3408

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Abstract

A 25-year-old man presented with acute kidney injury (AKI), massive proteinuria and hyperuricemia after epileptic seizures. His AKI improved along with the disappearance of proteinuria after corticosteroid treatment. A kidney biopsy revealed no significant glomerular abnormalities, but varying degrees of tubular injury, such as proximal tubular simplification, mild distal tubular proliferation, and Tamm-Horsfall protein-like material accumulation with extravasation into the interstitium, were noted. A further analysis revealed the intratubular depositions of uric acid crystals, indicating the involvement of acute uric acid nephropathy associated with seizures. Our patient's condition is rare, and the clinicopathological aspects of the diagnostic challenges are discussed.

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