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By Bruno Campolmi

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Our Series (22 Patients) 37 Fig. 39. MRI before and after the administration of Gd–DTPA. 2/1). 1/1). 1/1). At the arrows in the lower row, the uptake of Gd– DTPA was low in some areas Fig. 40. Bone scan with MDP. The patchy findings were more marked in the left kidney Patient 19: a 39-year-old man This patient required hemodialysis for ALPE. Delayed CT and a bone scan with MDP in the recovery phase showed patchy lesions (these imaging procedures were performed in conjunction with another patient with myoglobinuric acute renal failure due to a malignant syndrome).

A presecretory reabsorption defect was suggested. Patient 9: a 24-year-old man This patient participated in a 200-m relay race at an athletics meeting on October 10. After dinner, a dull pain in his left flank occurred and gradually worsened, but it differed from colic. There was no decrease in urine volume or dark urine. At 2330 hours, the patient attended the Emergency Outpatient Unit of our hospital because of the pain. An intramuscular injection of scopolamine butylbromide relieved the Exercise Flu-like symptoms Slight fever Kidney biopsy CT scan Pyrazinamide benzbromarone test Nausea/vomiting Edema FEUA (%) Serum creatinine 6 Uric acid 5 (mg/dl) Serum creatinine 4 3 Uric acid 2 1 0 1987.

Therefore, anaerobic exercise may enhance angiotensin-related renovascular constriction in the presence of renal hypouricemia, causing patchy renal ischemia. The other hypothesis is related to the fact that the reabsorption of uric acid is impaired in patients with renal hypouricemia. Even when exercise increases the serum uric acid level, uric acid is not reabsorbed, thus gradually increasing the tubular level of uric acid. In addition, exercise-related dehydration and urine acidification may result in tubular occlusion via the crystallization of uric acid, causing ALPE.

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