Pseudohypercreatininemia After Surgery for Aortic Dissection: A Case Report

Authors

• Ayako Tasaki
• Makoto Fukuda
• Yuki Ikeda
• Masatora Yamasaki
• Ikko Yamaguchi
• Shinichi Aishima
• Motoaki Miyazono

Language

English

Publication Date

7-25-2023

Journal

BMC Nephrology

DOI

10.1186/s12882-023-03275-2

PMID

37491221

PMCID

PMC10369689

PubMedCentral® Posted Date

7-25-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Elevated creatinine concentrations often indicate acute renal injury and renal biopsies are considered in this situation. However,pseudohypercreatininemia is potential cause of elevated creatinine concentrations, and invasive interventions should be avoided.

Case presentation: A 54-year-old woman underwent surgery for descending aortic dissection.Nine days postoperatively, her creatinine concentration increased from 1 mg/dl to 5.78 mg/dl (normal range, 0.47-0.7 mg/dl). Azotemia and hyperkalemia were absent and physical examination findings were unremarkable. Cystatin C concentration was 1.56 mg/l (normal range, 0.56-0.8 mg/l) and pseudohypercreatininemia was suspected. Testing with different reagents showed a creatinine concentration of 0.84 mg/dl. Immunoglobulin (Ig)G was markedly elevated, and creatinine and IgG fluctuated in parallel, suggesting the cause of the pseudohypercreatininemia. IgG4 was also elevated at 844 mg/dl. Immunosuppressive steroid therapy effectively decreased the IgG concentration and resolved the pseudohypercreatininemia.

Conclusions: In cases of elevated creatinine concentration with the presence of abnormal proteins, pseudohypercreatininemia should be considered. We report a rare case of pseudohypercreatininemia caused by polyclonal IgG.

Keywords

Female, Humans, Middle Aged, Acute Kidney Injury, Aortic Dissection, Biomarkers, Creatinine, Cystatin C, Immunoglobulin G, Immunosuppressive Agents, Postoperative Complications, Steroids, Pseudohypercreatininemia, Acute kidney injury, Enzymatic method, Case report, IgG4

Published Open-Access

yes

Recommended Citation

Tasaki, Ayako; Fukuda, Makoto; Ikeda, Yuki; et al., "Pseudohypercreatininemia After Surgery for Aortic Dissection: A Case Report" (2023). Children’s Nutrition Research Center Staff Publications. 353.
https://digitalcommons.library.tmc.edu/staff_pub/353