Nephrotic syndrome and acute kidney injury induced by malathion toxicity

BMJ Case Rep. 2017 Nov 9:2017:bcr2017220733. doi: 10.1136/bcr-2017-220733.

Abstract

We treated a case of acute kidney injury and nephrotic syndrome after malathion inhalation. A 69-year-old Japanese man presented with oedema 15 days after inhalation of malathion, a widely used pesticide. Serum albumin was 2.4 g/dL, urinary protein 8.6 g/gCr and serum creatinine 2.5 mg/dL. Kidney biopsy revealed tubular cell damage, epithelial cell damage in glomeruli and diffuse foot process effacement in electron microscopy. Acute kidney injury progressed to treatment with dialysis. Renal function recovered after corticosteroid administration from the 43rd day after admission. Malathion inhalation should be ruled out as a differential diagnosis in individuals who develop acute kidney injury and nephrotic syndrome, especially in rural-dwelling patients.

Keywords: acute renal failure; nephrotic syndrome; proteinurea; renal medicine; toxicology.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / complications
  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / therapy
  • Aged
  • Diagnosis, Differential
  • Humans
  • Malathion / toxicity*
  • Male
  • Nephrotic Syndrome / chemically induced
  • Nephrotic Syndrome / complications
  • Nephrotic Syndrome / diagnosis*
  • Nephrotic Syndrome / therapy
  • Pesticides / toxicity*
  • Renal Dialysis

Substances

  • Pesticides
  • Malathion