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Diffusion-weighted MRI of exercise-induced acute renal failure (ALPE)

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Abstract

Acute renal failure with severe loin pain induced by anaerobic exercise (ALPE) is a rare condition that is accompanied by wedge-shaped contrast enhancement on computed tomography (CT) without evidence of rhabdomyolysis. In two pediatric cases with ALPE, we tried to determine the relationship between findings from CT and magnetic resonance imaging (MRI). Case 1 involved a 13-year-old Japanese girl with a diagnosis of ALPE with normo-uricemia. Contrast-enhanced CT after 24 and 48 h showed a wedge-shaped excretion delay for the contrast media. A clear wedge-shaped signal hyperintensity matching the CT images was obtained by diffusion-weighted MRI. Case 2 involved a 16-year-old boy who presented with a second attack of ALPE after diagnosis of ALPE with hypouricemia 1 year earlier. Only diffusion-weighted imaging was performed. Clear wedge-shaped signal hyperintensity was apparent, similar to Case 1. MRI is safer than contrast-enhanced CT for patients with ALPE. Diffusion-weighted MRI is a very useful examination for diagnosing ALPE, providing noninvasive detection of lesions peculiar to ALPE.

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Authors and Affiliations

  1. Department of Pediatrics, Kanazawa Medical Center, National Hospital Organization, 1–1 Shimo-Ishibiki, Kanazawa, Ishikawa, 920–8650, Japan

    Kazuhide Ohta, Kazunori Mizuno & Shinobu Sakazume

  2. Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan

    Tadafumi Yokoyama, Masaki Shimizu & Akihiro Yachie

  3. Department of Pediatrics, Kanazawa Medical University Hospital, Uchinada, Ishikawa, Japan

    Takuma Fujiki & Yutaka Saikawa

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  1. Kazuhide Ohta
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  2. Tadafumi Yokoyama
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  3. Masaki Shimizu
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  4. Kazunori Mizuno
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  5. Shinobu Sakazume
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  6. Takuma Fujiki
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  7. Yutaka Saikawa
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  8. Akihiro Yachie
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Correspondence to Kazuhide Ohta.

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Ohta, K., Yokoyama, T., Shimizu, M. et al. Diffusion-weighted MRI of exercise-induced acute renal failure (ALPE). Pediatr Nephrol 26, 1321–1324 (2011). https://doi.org/10.1007/s00467-011-1869-y

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  • DOI: https://doi.org/10.1007/s00467-011-1869-y

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