Shapiro's syndrome: Excessive sweating may cause renal failure

A 55-year-old male is admitted to the hospital with acute renal failure (ARF). He complains of generalized weakness, chills and excessive sweating.

His past medical history includes AFib, obesity, mild mental retardation and HTN.

During physical examination, all skin surfaces are wet and he is shivering under 4 blankets which are wet.

What is the cause for his ARF?

What are the typical finding seen on the MRI of the brain?

Read more on ClinicalCases.org: Acute renal failure due to hyperhidrosis secondary to Shapiro's syndrome.

Image source: Sweat, Shaylor's photostream, Creative Commons license. The image is not related and does not show the patient.