Abstract
Bile cast nephropathy (BCN) is seen in patients who have acute kidney injury and severe hyperbilirubinemia due to a wide range of hepatobiliary system diseases. Findings seen by renal biopsy include acute tubular injury with necrotic and sloughed epithelial cells, yellow-green pigment within tubular epithelial cells, and pigmented granular casts. Hall's special stain for bile turns these casts green. In recent years, BCN has been described in a small number of case reports and clinical studies primarily in the setting of severe liver dysfunction. We present 2 diverse cases of BCN. The first involves an adult with hepatorenal syndrome secondary to alcoholic steatohepatitis and early cirrhosis. Second, we describe the first reported case of BCN in a child with fulminant hepatic failure due to Wilson's disease. Our cases expand the spectrum of causative diseases, and they provide further evidence that BCN is a distinct pathologic entity which may be found in both adult and pediatric patients with a variety of severe liver diseases.
Original language | English (US) |
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Pages (from-to) | 207-215 |
Number of pages | 9 |
Journal | Case Reports in Nephrology and Dialysis |
Volume | 8 |
Issue number | 3 |
DOIs | |
State | Published - Sep 1 2018 |
Keywords
- Bile cast nephropathy
- Cholestatic liver disease
- Hepatorenal syndrome
- Wilson's disease
ASJC Scopus subject areas
- Nephrology