Acute renal failure in a patient with paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder characterized by low-grade, chronic hemolytic anemia accompanied by either thrombocytopenia or leucopenia. Kidney involvement is usually benign and secondary to chronic tubular deposition of hemosiderin. Acute renal failure may occur in association with a hemolytic crisis. We report the case of a 70-year-old Caucasian woman with PNH who developed reversible acute renal failure requiring hemodialysis following a gastointestinal illness. Renal biopsy demonstrated acute tubular necrosis with considerable hemosiderin deposition, but no evidence of vascular thrombosis.