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"Acute Kidney Injury"

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Paroxysmal nocturnal hemoglobinuria presenting with acute kidney injury in an 18-year-old male: a case report
Anum Rizwan, Sajid Islam Bhatti, Huda Raja, Tajammul Waqar, Sidra German
Received September 15, 2025  Accepted October 9, 2025  Published online December 24, 2025  
DOI: https://doi.org/10.4082/kjfm.25.0273    [Epub ahead of print]
Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired hematological disease resulting from somatic PIGA gene mutations. These mutations cause a deficiency in glycosylphosphatidylinositol-anchored–anchored proteins such as CD55 and CD59 on blood cell surfaces, leading to uncontrolled complement-mediated hemolysis. Although this condition is typically identified in individuals in their third or fourth decades of life, diagnosis during late adolescence is rare. Renal complications are a known feature of PNH; however, they present more frequently as a gradual decline in function rather than as a severe acute insult. This report describes the unusual case of an 18-year-old male who presented with a 6-month history of intermittent dark urine followed by an acute illness. Laboratory evaluation revealed severe Coombsnegative hemolytic anemia, significantly elevated lactate dehydrogenase levels, and acute kidney injury requiring immediate hemodialysis. Renal biopsy-confirmed pigment nephropathy, and high-sensitivity flow cytometry detected a large PNH clone, establishing the diagnosis of classical PNH. The patient's renal function improved with supportive care, but hemolysis persisted. This case highlights the fact that PNH can manifest in young adults with acute kidney injury as the primary presenting symptom. Including PNH in the differential diagnosis of patients with unexplained hemolytic anemia and renal impairment is crucial, even in atypical age groups. Prompt diagnosis is vital for initiating appropriate management, including supportive measures and the consideration of complementary inhibitor therapy, to improve outcomes.
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Exertional Rhabdomyolysis after Spinning
Youjin Jeong, Hyuk-Jung Kweon, Eun-Jung Oh, Ah-Leum Ahn, Jae-Kyung Choi, Dong-Yung Cho
Korean J Fam Med 2016;37(6):356-358.   Published online November 18, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.6.356

Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.

Citations

Citations to this article as recorded by  
  • The Emergence of a First Cycle Spinning Session as a Major Cause of Rhabdomyolysis in China
    Chuqi Gao, Jie Lv, Ruiqing Dong, Hao Li, Huan Yan, Lei Chen, Qiang Song, Giulia Sapuppo, Theocharis Koufakis, Richard J. MacIsaac, Liya Fan, Wei Qiang, Suraiya Saleem
    International Journal of Clinical Practice.2025;[Epub]     CrossRef
  • Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review
    Yoshio Masuda, Rachel Wam, Benjamin Paik, Clara Ngoh, Andrew MTL Choong, Jun Jie Ng
    The Physician and Sportsmedicine.2023; 51(4): 294.     CrossRef
  • Time expression recognition and normalization: a survey
    Xiaoshi Zhong, Erik Cambria
    Artificial Intelligence Review.2023; 56(9): 9115.     CrossRef
  • Clinical outcomes of hospitalised individuals with spin-induced exertional rhabdomyolysis
    Shermane Yun Wei Lim, Chiara Jiamin Chong, Zhenghong Liu, Juliana Yin Li Kan
    Annals of the Academy of Medicine, Singapore.2023; 52(7): 356.     CrossRef
  • Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review
    Daniel Rojas‐Valverde, Braulio Sánchez‐Ureña, Jennifer Crowe, Rafael Timón, Guillermo J. Olcina
    European Journal of Sport Science.2021; 21(2): 261.     CrossRef
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