がんの科学と治療

Bile Cast Nephropathy in a Patient with Refractory Hepatocellular Carcinoma

Abstract

Hirotaka Sato, Yuko Iwashita, Kentaro Takase, Ryuichi Yoshimura, Shiho Hasegawa, Kaori Yoshikane, Shohei Fukunaga, Masaya Hanada, Yasumasa Tada, Shuichi Sato, Riruke Maruyama, Naohiko Imai, Yugo Shibagaki and Takafumi Ito

A 41-year-old Japanese male who had been treated for refractory hepatocellular carcinoma and liver failure was admitted with pleural empyema and subphrenic abscess. Broad spectrum antibiotics and thoracic drainage was performed but the infection and his liver failure got worse, and he developed acute kidney injury (AKI). The patient died and autopsy was performed. From the liver autopsy findings, the cause of this patient’s severe jaundice was thought to be biliary obstruction, and the kidney autopsy indicated that the cause of AKI was due to severe hyperbilirubinemia. From these findings, we concluded that the cause of AKI was bile cast nephropathy.