Acute Kidney Injury Associated with Disseminated Intravascular Coagulation that Developed after a Hysterectomy in a Patient with Probable Catastrophic Antiphospholipid Syndrome

Acute kidney injury associated with disseminated intravascular coagulation (DIC) and a coagulation factor defect may develop with infection, malignancy, severe trauma, or obstetric complications. However, a gynecological etiology, such as hysterectomy, in a patient with adenomyosis has rarely been reported. We describe a case of a 42-year-old women who presented with DIC and acute kidney injury after a total hysterectomy. We thought that the cause for the acute kidney injury might be small vascular thrombosis and acute tubulointerstital nephritis due to probable catastrophic antiphospholipid syndrome with DIC. The patient was successfully treated with steroid therapy. (Korean J Med 2012;82:739-743)

[1]  G. Espinosa,et al.  Catastrophic antiphospholipid syndrome: updated diagnostic algorithms. , 2010, Autoimmunity reviews.

[2]  A. Magos,et al.  Two cases of myomectomy complicated by intravascular hemolysis and renal failure: disseminated intravascular coagulation or hemolytic uremic syndrome? , 2010, Fertility and sterility.

[3]  Jong-Woo Yoon,et al.  Catastrophic antiphospholipid syndrome presenting with disseminated intravascular coagulation, cerebral infarction, and acute respiratory distress syndrome , 2009 .

[4]  R. Asherson Multiorgan failure and antiphospholipid antibodies: the catastrophic antiphospholipid (Asherson's) syndrome. , 2005, Immunobiology.

[5]  G. Espinosa,et al.  Disseminated intravascular coagulation in catastrophic antiphospholipid syndrome: clinical and haematological characteristics of 23 patients , 2005, Annals of the rheumatic diseases.

[6]  S. Yamada,et al.  [Tubulointerstitial nephritis in the case of acute renal failure from sepsis after a cat bite]. , 2001, Nihon Jinzo Gakkai shi.

[7]  M. García-Carrasco,et al.  Antiphospholipid syndrome without antiphospholipid antibodies at the time of the thrombotic event: transient 'seronegative' antiphospholipid syndrome? , 1997, Clinical and experimental rheumatology.

[8]  R. Wiggins,et al.  Tissue factor production by cultured rat mesangial cells. Stimulation by TNF alpha and lipopolysaccharide. , 1990, Kidney international.

[9]  J. Sánchez-Guerrero,et al.  Fall in antiphospholipid antibody at time of thromboocclusive episodes in systemic lupus erythematosus. , 1989, The Journal of rheumatology.

[10]  P. Tipping,et al.  Macrophage-induced glomerular fibrin deposition in experimental glomerulonephritis in the rabbit. , 1985, The Journal of clinical investigation.