Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report

Table 1 Selected indicators after admission

	Day 3	Day 41	Day 5	Day 6	Day 7	Day 10	Day 122	Day 14	Day 17	Day 193	Day 22	Day 244	Day 31	Reference
Liver function
ALT		2739.00	1674.00	1052.00	684.00	264.00		86.00	61.00	39.00				7-40 U/L
AST		1399.00	416.00	155.00	76.00	37.00		21.00	23.00	21.00				13-35 U/L
Glutamyl transpetidase		212.00	178.00	162.00	141.00	104.00		78.00	89.00	80.00				10-60 U/L
Total bile acid			32.30	14.80	17.00									< 9.67 mol/L
Glucocholic acid			29.85	13.10	11.60									< 5.80 mol/L
Total bilirubin		49.70	32.70	25.30	17.30	12.70		15.30	15.70	12.50				3.4-21.1 μmol/L
Direct bilirubin		43.50	26.60	19.20	12.70	8.10		8.30	8.90	7.40				< 6.8 μmol/L
Albumin		42.90	38.70	35.90	35.20	36.50		36.00	49.10	48.50				40.0-55.0 g/L
Renal function
Serum creatinine	344.00	505.00	521.00	551.00		589.00		590.00	580.00	458.00	242.00	164.00	104	46-920 μmol/L
Urea	15.88	19.60	17.30	15.00		10.20		11.40	14.80	18.30	15.80	12.20	6.54	2.5-6.4 mmol/L
Uric acid	647.00	739.80	550.50	500.30		454.80		391.30	406.50	427.10	375.10			95.2-446.3 mmol/L
Uronoscopy
Urine protein		2+(1)				1+(0.5)
Urine chlorine								187.8						110-250 mmol/24 h
Urine sodium								221.9						40-220 mmol/24 h
Urine potassium								19.85						25-100 mmol/24 h
Urine uric acid								0.7						1.5-4.4 mmol/24 h
24 h urine protein								303						30-150 mg/24 h
Urine-NAG		22.9												0.3-11.5 U/L
Urine IgG		149.0												< 9.6 mg/L
Urine β2-microglobulin		3.44												< 0.2 mg/L
Urine α1-microglobulin		34.0												< 12.0 mg/L
Urine transferrin		55.0												< 2.3 mg/L
Urine amylase		542.00												32-641 U/L
Routine blood test
Leukocytes	5.7		5.60		7.00	6.90	6.40	8.50		6.90	6.40		5.9	3.5-9.5 × 109/L
Neutrophils	4.7		4.60		5.50	5.10	4.90	7.10		4.80	4.30		3.9	2.0-7.0 × 109/L
Lymphocytes	0.56		0.60		0.90	1.00	0.90	0.90		1.40	1.40		1.5	0.8-4.0 × 109/L
Hemoglobin	125		116.00		114.00	105.00	93.00	92.00		89.00	91.00		83	115-150 g/L
Platelets	156		128.00		116.00	122.00	98.00	84.00		111.00	156.00		161	125-350 × 109/L
Inflammatory indicators
C-reactive protein	1.4			12.90		6.10								< 10.0 mg/L
Procalcitionin					3.31						0.12			< 0.50 ng/mL
Serum amyloid A		89.60									7.60			0-10 mg/L
Erythrocyte sedimentation rate		9												< 20 mm/h
Coagulation function
Prothrombin time		12.40			11.20		11.50							9.5-14.1 s
Activated partial thromboplastin time		25.50					27.70							25.1-36.5 s
Thrombin time		17.20					14.60							11.8-17.8 s
D-dimer		7.20			1.69		4.84							< 0.50 mg/L
Blood gas analysis
PH		7.35												7.35-7.45
PaCO2		29.4												35.0-48.0 mmHg
PaO2		81.9												80.0-100.0 mmHg
Actual bicarbonate radical		16												22-27 mmol/L
Standard bicarbonate radical		18												21-25 mmol/L
Electrolytes
K+	4.60	4.40	4.20	3.80	3.80	3.50		3.40	3.80	3.80	4.00	4.00		3.5-5.3 mmol/L
Na+	138.00	133.00	135.00	137.00	137.00	137.00		136.00	137.00	139.00	136.00	138.00		137-147 mmol/L
Cl-	103.00	100.00	99.00	99.00	101.00	99.00		95.00	90.00	95.00	94.00	98.00		99-110 mmol/L
P		1.50	1.34	1.64	1.65	1.30		1.22		2.04	1.64			0.83-1.48 mmol/L
Ca2+	2.29	2.22	2.18	2.21	2.10	2.17		2.10		2.31	2.49			2.15-2.5 mmol/L
Other indicators
Serum ferritin										770.7				11.0-306.8 ng/mL
Transferrin saturation										18				15%-45%
Folic acid										11.4				3.1-20.5 ug/L
Vitamin B12										453				187-883 ng/L
Erythropoietin										3.8				4.30-29.00 mIU/mL
Parathyroid hormone		75.10								151.40				15-65 pg/mL
Serum β2-microglobulin		7.32												1.3-2.7 mg/L
Serum amylase	159.00	137.00			205.00									30-110 U/L
Heart function	Creatine kinase and Troponin normal range
Hepatophilic virus	HAV, HBV, HCV, HEV, and TORCH were negative
Immunization indicators	ANA, anti-GBM and ANCA negative; IgE 212 IU/mL (< 100 IU/mL), C3 0.57 (0.9-1.8 g/L), C4 0.1 (0.1-0.4 g/L), C1q 101 (159-233 mg/L). IgA, IgG, and IgM were normal; Widal’s test negative

¹Day 4: Convention hemodialysis was performed.

²Day 12: Patient’s urine output increased to 1400 mL.

³Day 19: Liver function improved and dialysis was withdrawn.

⁴Day 24: The patient was discharged with serum creatinine at 164 μmol/L.

IgG: Immunoglobulin G; HAV: Hepatitis A virus; HBV: Hepatitis B virus; HCV: Hepatitis C virus; HEV: Hepatitis E virus; ANA: Antinuclear antibodies; anti-GBM: Anti-glomerular basement membrane antibody; ANCA: Antineutrophil cytoplasmic antibodies; IgE: Immunoglobulin E; IgA: Immunoglobulin A; IgM: Immunoglobulin M; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; NAG: N-acetyl-beta-D-glucosaminidase; TORCH: Toxoplasma gondii, other, rubella virus, cytomegalovirus and herpes simplex virus.