Hypokalemic Rhabdomyolysis Induced Acute Renal Failure As a Presentation of Coeliac Disease

Yıl 2012, Cilt: 2012 Sayı: 1, 103 - 105, 01.01.2012

Funda Sarı Ayşe Güneş Metin Sarıkaya Mustafa Eren Ahmet Korkmaz Ramazan Çetinkaya Hasan Can Nur Tukel

https://doi.org/10.5174/tutfd.2010.04289.1

Öz

Adult coeliac disease commonly presents without classical symptoms as chronic diarrhea and weight loss. We describe the case of a 31-year-old woman with persistent life-threatening hypokalemia, acute renal failure, and acute quadriplegia due to diarrhea that had continued for one month. Although there are cases of coeliac disease diagnosed with hypokalemic rhabdomyolysis in the literature, none of the cases developed acute renal failure. This is the first case in the literature diagnosed with acute renal failure due to hypokalemic rhabdomyolysis as a presentation of coeliac disease. In acute renal failure cases that present with hypokalemic rhabdomyolysis due to severe diarrhea, coeliac disease should be considered as a differential diagnosis despite the negative antigliadin IgA antibody. Turkish Başlık: Çöliak hastalığı prezentasyonu olarak hipokalemik rabdomiyoliz ilişkili akut böbrek yetmezliği Anahtar Kelimeler: Çöliak hastalığı, akut böbrek yetmezliği, hipokalemik rabdomiyoliz Erişkin çöliak hastalığı sıklıkla kronik ishal ve kilo kaybı gibi klasik semptomlar olmaksızın görülür. Biz ishale bağlı hayatı tehdit edici hipokalemi, akut böbrek yetmezliği ve akut quadripleji gelişen 31 yaşında bir kadın çöliak hastası sunmaktayız. Literatürde hipokalemik rabdomiyolizli çöliak hastaları sunulmasına karşın akut böbrek yetmezliği gelişmiş hasta bildirilmemiştir. Bu vaka hipokalemik rabdomiyolize bağlı akut böbrek yetmezliği ile başvuran ilk çöliak hastasıdır. Şiddetli ishale bağlı hipokalemik rabdomiyoliz ile başvuran akut böbrek yetmezliği vakalarında anti gliadin IgA antikoru negatif olsa bile ayırıcı tanıda çöliak hastalığı da düşünülmelidir.

Anahtar Kelimeler

Adult coeliac disease, acute renal failure, hypokalemic rhabdomyolysis

Hypokalemic Rhabdomyolysis Induced Acute Renal Failure As a Presentation of Coeliac Disease

Öz

Kaynakça

• 1. Larner AJ. Potassium depletion and rhabdomyolysis. BMJ 1994;308:136. [CrossRef]
• 2. Williams SG, Davison AG, Glynn MJ. Hypokalaemic rhabdomyolysis: an unusual presentation of coeliac disease. Eur J Gastroenterol Hepatol 1995;7:183-4.
• 3. Selimoglu MA, Alp H, Ertekin V. Is rhabdomyolysis a rare manifestation in celiac disease? Yonsei Med J 2004;45:759-60.
• 4. Barta Z, Miltenyi Z, Toth L, Illes A. Hypokalemic myopathy in a patient with gluten-sensitive enteropathy and dermatitis herpetiformis Duhring: a case report. World J Gastroenterol. 2005;11: 2039-40.
• 5. Peña Porta JM, Calvo Beguería E, de Vera Floristán CV, Oncins Torres R. Hypokalemic rhabdomyolysis and tetany as a presentation of celiac disease in an adult. Nefrología 2008;28:343-6.
• 6. Casellas i Jordà F. Celiac disease. Med Clin (Barc) 2006;126: 137-42.
• 7. Jones S, D’Souza C, Haboubi NY. Patterns of clinical presentation of adult coeliac disease in a rural setting. Nutr J 2006,5:24. [CrossRef]
• 8. Ankelo M, Kleimola V, Simell S, Simell O, Knip M, Jokisalo E, et al. Antibody responses to deamidated gliadin peptide show high specificity and parallel antibodies to tissue transglutaminase in developing coeliac disease. Clin Exp Immunol 2007;150:285-93. [CrossRef]
• 9. Singhal PC, Abramovici M, Venkatesan J, Mattana J. Hypokalemia and rhabdomyolysis. Miner Electrolyte Metab 1991;17: 335-9.
• 10. Ward M. Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med 1988;148:1553-7. [CrossRef]
• 11. Grossman R, Hamilton R, Morse B, Penn A, Goldberg M. Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 1974;291:807-11. [CrossRef]
• 12. Menahem SA, Perry GJ, Dowling J, Thomson NM. Hypokalaemia-induced acute renal failure. Nephrol Dial Transplant 1999;14:2216-8. [CrossRef]
• 13. Kishore B, Thurlow V, Kessel B. Hypokalaemic rhabdomyolysis. Ann Clin Biochem 2007;44:308-11. [CrossRef]
• 14. Llach F, Felsenfeld AJ, Haussler MR. The pathophysiology of altered calcium metabolism in rhabdomyolysis-induced acute renal failure. Interactions of parathyroid hormone, 25-hydroxycholecalciferol, and 1,25-dihydroxycholecalciferol N Engl J Med 1981;305:117-23. [CrossRef]
• 15. Akmal M, Bishop JE, Telfer N, Norman AW, Massry SG. Hypocalcemia and hypercalcemia in patients with rhabdomyolysis with and without acute renal failure. J Clin Endocrinol Metab 1986;63:137-42 [CrossRef]