Case Studies
1 April 1968

Arsine-Induced Anuria: A Correlative Clinicopathological Study with Electron Microscopic Observations

Publication: Annals of Internal Medicine
Volume 68, Number 4

Abstract

A correlative clinicopathological study was made of a 32-year-old truck driver with arsine-induced anuria. Treatment consisted of massive exchange whole blood transfusions to remove the "arsenic-hemoglobin complex," prolonged peritoneal dialysis, and extracorporeal hemodialysis with supportive, nutritional, and medical measures as needed. Five serial renal biopsy specimens were studied by light and four by electron microscopy.
Acute tubular necrosis was followed by rapid regeneration of tubular cells. However, in the proximal tubules, these new cells had a modified and apparently functionally defective structure. Return to a normal appearance took place in a period of more than 6 months. A striking morphological feature was a diffuse interstitial fibrosis which became focal. This together with profound nephron atrophy produced irreversible chronic renal disease. A literature review was made of arsine-induced anuria, its treatment and prognosis. Finally, the morphological changes were discussed as to the damage and repair in each of the four major kidney components: tubules, glomeruli, interstitium, and vessels.

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 68Number 41 April 1968
Pages: 853 - 866

History

Published in issue: 1 April 1968
Published online: 1 December 2008

Keywords

Authors

Affiliations

ROBERT C. MUEHRCKE, M.D., F.A.C.P.
Chicago and Oak Park, Illinois
CONRAD L. PIRANI, M.D.
Chicago and Oak Park, Illinois
From the Renal and Nutritional Unit, Department of Medicine, Presbyterian-St. Luke's Hospital and the Department of Medicine and Pathology, University of Illinois College of Medicine, Chicago, Ill.; and the Department of Medicine, West Suburban Hospital, Oak Park, Ill.
This study was supported by grant HE-09770-03, U. S. Public Health Service, Washington, D. C.
This paper was presented in part at the 45th Annual Session of the American College of Physicians, Atlantic City, N. J., April 6-10, 1964.
Requests for reprints should be addressed to Robert C. Muehrcke, M.D., West Suburban Hospital, Oak Park, Ill. 60302.

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ROBERT C. MUEHRCKE, CONRAD L. PIRANI. Arsine-Induced Anuria: A Correlative Clinicopathological Study with Electron Microscopic Observations. Ann Intern Med.1968;68:853-866. doi:10.7326/0003-4819-68-4-853

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