ACUTE TUBULAR NECROSIS AFTER TRANSFUSION REACTION DUE TO ANTI-KELL ANTIBODIES

Abstract

The pathophysiological alterations in the kidneys of previously healthy individuals who suddenly develop oliguria or anuria have recently been more clearly elucidated. In 1942, Bywaters¹described the clinical and pathological features of the crush syndrome. Lucke²reported that similar ischemic lesions of the tubules could result from several etiological factors and suggested the term lower nephron nephrosis. Oliver,³however, demonstrated that the terminal part of the proximal convoluted tubule is involved as often as the distal tubule. Such cases of acute renal failure continue to be described as lower nephron nephrosis, but the syndrome is more appropriately termed acute tubular necrosis. Numerous etiological factors may produce this syndrome. However, transfusion reactions continue to be one of the most frequent causes. The present report describes a patient who developed acute' renal insufficiency after an incompatible blood transfusion due to anti-Kell antibodies but in whom the usual manifestations of