A CASE REPORT OF RECOVERY OF ACUTE CORTICAL NECROSIS

Abstract

A 25-year-old female with acute cortical necrosis following delivery, who was saved by hemodialysis, is reported.
After delivery, massive bleeding happened due to laceration of the cervix of the uterus and the vagina. She fell into a shock. The next day, ligation of internal iliac arteries and hysterectomy were done with the help of blood transfusion. She recovered from the shock, but anuria occurred. Under the diagnosis of acute renal failure and disseminated intravascular coagulation (DIC), she was maintained by hemodialysis. However, the renal function was not improved. On the four months after the onset of her illness, we performed renal biopy. The histological diagnosis was acute cortical necrosis. More than one year has passed since her dilivery, but she has continued hemodialysis twice a week. Her creatinine clearance is 13ml/min.
Including our case, 62 cases of acute cortical necrosis have been reported in the Japanese literature. Only 11 cases were saved. Acute cortical necrosis is a disease with poor prognosis. A statistical study of these cases were done. We revealed the pathogenesis of acute cortical necrosis as DIC.