Hemoglobinemia and hemoglobinuria with associated acute renal insufficiency has been noted following blood transfusions (1, 2), crush injuries (3), the accidental infusion of distilled water (4), with malaria (5), following drug ingestion (5, 6, 7), with certain infections (8, 9), in paroxysmal nocturnal hemoglobinuria (10, 11), with thermal burns (12), and in paroxysmal cold hemoglobinuria (13).
Idiopathic or symptomatic acquired auto-immune hemolytic anemia with hemoglobinemia and hemoglobinuria is an unusual cause of acute renal failure. This is evidenced by our finding of only 5 case reports (14-18) in the literature. Two of the cases (14, 15) would be classified as