Pigment cast nephropathy; time to revisit the diagnosis

Pigment cast nephropathy is one of the most severe complications of rhabdomyolysis. It is an important cause of renal failure requiring renal replacement therapy. We report the case of a 23-year-old man who presented with short febrile illness with hyperpyrexia and altered sensorium. Non-contrast CT-brain and CSF analysis were normal. He later developed petechial rashes with thrombocytopenia followed by frank hematuria and worsening renal functions. A kidney biopsy was performed, which revealed findings of myoglobin cast nephropathy