[Acute renal failure following dehydration and hemolytic crisis due to pneumonia in a case of PNH].

A 41-year-old female, who had been diagnosed as having paroxysmal nocturnal hemoglobinuria (PNH) in 1985, was admitted to our hospital with cough, fever, diarrhea, vomiting and palpitation in April 1988. The chest X-ray showed pneumonia in her right lung. In the peripheral blood, red blood cell count was 1.64 x 10(6)/microliters, hemoglobin 4.7 g/dl and reticulocytes 19%. The levels of serum LDH, indirect bilirubin and creatinine were high. Pneumonia improved by the administration of antibiotics, however, anemia and renal failure deteriorated. After washed red blood cell transfusions totalling 2,000 ml and six times of hemodialysis, renal function returned to normal. This patient with PNH appeared to have developed acute renal failure by dehydration and hemolytic crisis due to pneumonia.