AKI and Hyponatremia in a Patient with Crohn Disease: A Case Report

Introduction: Crohn's disease (CD) and ulcerative colitis are examples of inflammatory bowel disease (IBD), which frequently has systemic symptoms that extend outside of the digestive tract. Although they are less frequent, renal and urologic problems can present serious treatment difficulties. Glomerulonephritis is an uncommon but serious extraintestinal manifestation. This case report demonstrates an uncommon correlation between immunoglobulin A nephropathy (IgAN), the most common glomerulonephritis worldwide and Crohn's disease. Case Description: A week-long history of malaise, flu-like symptoms, and myalgias brought this 47-year-old White female patient to the emergency room. She had a history of Crohn's disease following ileostomy. Severe electrolyte abnormalities and acute kidney damage (AKI) with a creatinine level of 10.7 mg/dL were discovered during laboratory examinations. Renal ultrasonography revealed modest bilateral renal enlargement without hydronephrosis or calculi, despite stable vitals and an unremarkable physical examination. Urine culture came back negative, but urinalysis revealed severe hematuria, pigmented granular casts, and proteinuria. The patient's sodium and creatinine levels gradually improved subsequent to fluid restriction, desmopressin and hypertonic saline. Subsequently, a kidney biopsy demonstrated IgAN. Notably, at the time of the development of renal failure, the patient was not receiving immunosuppressive medicine and was not going through an aggressive flare-up of Crohn's disease. Discussion: This case emphasizes the need of keeping an eye out for renal involvement in individuals with IBD. The patient's abrupt renal failure and biopsy-proven IgAN demonstrate the intricate interactions between systemic immune responses and renal pathology in inflammatory bowel disease. Although uncommon, IgAN requires regular renal function monitoring in individuals with inflammatory bowel disease (IBD) in order to facilitate the early identification and treatment of any renal consequences. This report supports the use of an integrated strategy to patient management that takes into account both extraintestinal and gastrointestinal IBD symptoms. It is critical to research the pathogenic processes that connect IgAN and IBD and to ascertain if the two conditions are coincidental or suggest that they share common etiopathogenic pathways.