An unusual ultrasound appearance of renal hemosiderosis in acute sickle cell nephropathy

Madison Kocher, MD; Iris Martin, MD; Katherine Twombley, MD; Julie Kanter, MD; Sherron Jackson, MD; Sally Self, MD; Jeanne Hill, MD

Radiology Case Reports (Jan 2020)

An unusual ultrasound appearance of renal hemosiderosis in acute sickle cell nephropathy

Madison Kocher, MD,
Iris Martin, MD,
Katherine Twombley, MD,
Julie Kanter, MD,
Sherron Jackson, MD,
Sally Self, MD,
Jeanne Hill, MD

Affiliations

Madison Kocher, MD: Department of Pediatric Radiology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 210, MSC 323, Charleston, SC 29425 USA; Corresponding author.
Iris Martin, MD: Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 USA
Katherine Twombley, MD: Department of Pediatrics, Division of Nephrology, Medical University of South Carolina, 96 Jonathan Lucas Street CSB 428, MSC 608, Charleston, SC 29425 USA
Julie Kanter, MD: Department of Medicine, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL 35294 USA
Sherron Jackson, MD: Department of Pediatrics, Division of Hematology-Oncology, Medical University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425 USA
Sally Self, MD: Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 USA
Jeanne Hill, MD: Department of Pediatric Radiology, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 210, MSC 323, Charleston, SC 29425 USA

Journal volume & issue: Vol. 15, no. 1
pp. 26 – 30

Abstract

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Sickle cell disease is the most common inherited blood disorder in the United States. The primary driver of pathology is microvascular occlusion which affects multiple organ systems including the kidney. The renal pathology usually manifests as hematuria, proteinuria, or microalbuminuria, and up to 10% of individuals with homozygous sickle cell disease (HbSS) develop renal failure over their lifetime. At ultrasound, the most common finding is increased size with mild variation in echogenicity of the renal parenchyma. We report the ultrasound appearance of a case of acute sickle cell nephropathy with markedly abnormal, enlarged, and echogenic kidneys due to intravascular hemolysis and hemosiderosis, confirmed by biopsy. Knowledge of this potential presentation of sickle cell nephropathy may help aid in earlier diagnosis of renal complications and avoidance of unnecessary renal biopsies. Keywords: Sickle cell disease, Hemosiderosis, Sickle cell nephropathy, Papillary necrosis, Ultrasound

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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