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Unusual association of diseases/symptoms
Case report
Acute oxalate nephropathy associated with C lostridium difficile infection
  1. Deepali Pandey1,
  2. Ashish Verma2,
  3. Yanli Ding3,
  4. Priyamvada Singh4 and
  5. Hemant Magoo2
  1. 1 Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
  2. 2 Department of Nephrology, Saint Vincent Hospital, Worcester, Massachusetts, USA
  3. 3 Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  4. 4 Department of Nephrology, Comprehensive Transplant Center at The Ohio State University, Columbus, Ohio, USA
  1. Correspondence to Dr Deepali Pandey; drdeepalipandey05{at}gmail.com

Abstract

Acute oxalate nephropathy has been associated with chronic diarrheal illness and only one case has been reported due to acute diarrhea secondary to Clostridium difficile colitis. To the best of our knowledge, this is the second case report of acute oxalate nephropathy due to C . difficile colitis. A 75-year-old man with a medical history of hypertension, type 2 diabetes mellitus, chronic kidney disease stage IV, recent C . difficile colitis was admitted for acute kidney injury with a creatinine (Cr) of 8.54 mg/dL (baseline Cr, 2.3–2.6 mg/dL). His urinalysis did not show any eosinophils, casts or crystals. Antinuclear antibody, antineutrophil cytoplasmic antibody, complement levels (C3 and C4) and hepatitis screen were negative; a renal ultrasound visualized no hydronephrosis. A kidney biopsy showed widespread tubular oxalate crystal deposition suggestive of hyperoxaluria as the cause of acute kidney injury. In conclusion, an acute diarrheal illness like C . difficile colitis can cause acute oxalate nephropathy.

  • renal system
  • infection (gastroenterology)
  • acute renal failure
  • dialysis

https://doi.org/10.1136/bcr-2019-231099

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    Footnotes

    • Contributors DP: writing, critically reviewing and editing of the manuscript. AV: conception of the idea and critically reviewing the manuscript. YD: retrieval of images and critically reviewing the manuscript. PS: critically reviewing and editing the manuscript. HM: conception of the idea and critically reviewing the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.