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Case Reports
. 2018 Dec 5:5:e88.
doi: 10.14309/crj.2018.88. eCollection 2018.

Bile Cast Nephropathy Caused by Obstructive Pancreatic Carcinoma and Failed ERCP

Steffi Em van de Ven  1 , Kirill V Pavlov  1 , Jaap J Beutler  2 , Robbert Ch Scheffer  1
Affiliations
Case Reports

Bile Cast Nephropathy Caused by Obstructive Pancreatic Carcinoma and Failed ERCP

Steffi Em van de Ven et al. ACG Case Rep J. .

Abstract

Bile cast nephropathy is an often overlooked condition of acute renal injury in the setting of high serum bilirubin. While the exact pathophysiology remains unknown, possible mechanisms of renal injury are tubular obstruction from bile casts, direct toxicity from bile acids, and decreased renal perfusion due to hemodynamic changes. We present a patient with hyperbilirubinemia as a result of common bile duct obstruction due to pancreatic adenocarcinoma who developed anuric acute renal injury. Urine analysis showed bile casts that were highly suggestive for bile cast nephropathy. The patient underwent hemodialysis and bile drainage with full restoration of renal function.

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Figures

Figure 1
Figure 1
Creatinine and bilirubin levels over time.
Figure 2
Figure 2
Urine analysis with the presence of a bile cast (arrow).
See this image and copyright information in PMC

References

    1. Sequeira A, Gu X. Bile cast nephropathy: An often forgotten diagnosis. Hemodial Int. 2015;19:132–5. - PubMed
    1. Patel J, Walayat S, Kalva N, Palmer-Hill S, Dhillon S. Bile cast nephropathy: A case report and review of the literature. World J Gastroenterol. 2016;22:6328–34. - PMC - PubMed
    1. Tabatabaee SM, Elahi R, Savaj S. Bile cast nephropathy due to cholestatic jaundice after using stanozolol in 2 amateur bodybuilders. Iran J Kidney Dis. 2015;9:331–4. - PubMed
    1. van Slambrouck CM, Salem F, Meehan SM, Chang A. Bile cast nephropathy is a common pathologic finding for kidney injury associated with severe liver dysfunction. Kidney Int. 2013;84:192–7. - PubMed
    1. Sitprija V, Kashemsant U, Sriratanaban A, Arthachinta S, Poshyachinda V. Renal function in obstructive jaundice in man: Cholangiocarcinoma model. Kidney Int. 1990;38:948–55. - PubMed

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