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Case of the Month

  October 2016

A 49 -year-old man,  who is under the care of the nephrology clinic as he has CKD due to autosomal dominant polycystic kidney disease admitted to the nephrology ward being unwell. He has a 3 day history of left loin pain, mild nausea, and fever. On physical examination, the patient looks ill. Temperature is 39 °C , blood pressure is 130/85 mm Hg, pulse rate is 110 bpm, and respiratory rate is 22/min. Chest is clear and heart sounds are normal. Abdomen is soft but with left costovertebral angle tenderness and bowel sounds are audible.

Laboratory results :

HB                          135 g/l

WCC                       15,000 X109 /l

S. creatinine             2.1 mg/dl (186 mmol/l)

Urine Dipstick           Negative

Negative urine culture.

Ultrasound KUB : the left kidney is 16.7 cm, and the right kidney is 16.9 cm; multiple bilateral intraparenchymal cysts are noted consistent with polycystic disease.

 

What is the most likely diagnosis?

Read: 854 times Answered: 135 times Top score: 100%

Current Discussions

    • nsolomons's Avatar
    • ASN 2016: Late Breaking Clinic...
    • There are a couple of indirect outcomes that suggest that the reduction in proteinuria are not simply haemodynamic both of which were reported in the ASN presentation: 1- The anti ds DNA was...
    • 2 hours 18 minutes ago
    • delanaye's Avatar
    • TMO-MRC
    • bien sur il reste des indications...hyperPTH si pas d'hyoper Ca ni hyperP
    • 5 days 3 hours ago
    • DJAZIA's Avatar
    • TMO-MRC
    • c'est ce que je voulais savoir surtout, merci pour votre repose. donc pour répondre à ma réelle question , il reste plus d'indications pour le un alpha dans les TMO-MRC ?!
    • 5 days 3 hours ago
    • delanaye's Avatar
    • TMO-MRC
    • si le P est acceptable et la calcémie pas trop élevée, on peut essayer oui...sous controle de ces deux paramètres
    • 5 days 3 hours ago
    • DJAZIA's Avatar
    • TMO-MRC
    • même avec un bilan phospho calcique normal pas élevé ??
    • 5 days 3 hours ago

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