Rare renal manifestation of plasma cell disorder
CASE PRESENTATION: A 56 year old lady presented with 2 weeks history of nausea, vomiting, and unintentional weight loss, with reduced eff 01t tolerance. She has underlying type 2 diabetes mellitus, and hype1tension. On examination, blood pressure was 140 / 80mmhg, pallor conjunctivae, and other...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Society of Nephrology
2024
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| Online Access: | http://psasir.upm.edu.my/id/eprint/119071/ http://psasir.upm.edu.my/id/eprint/119071/1/119071.pdf |
| Summary: | CASE PRESENTATION: A 56 year old lady presented with 2 weeks history of
nausea, vomiting, and unintentional weight loss, with
reduced eff 01t tolerance. She has underlying type 2
diabetes mellitus, and hype1tension. On examination,
blood pressure was 140 / 80mmhg, pallor conjunctivae,
and other physical examination was normal. Her
investigations showed creatinine of 1214 umol/L, urea
24.3 mmol/L, eGFR of 2 ml/min/1.73m2, albumin 35 g/L,
total protein 71g/L, globulin 34g/L, albumin /globulin
ratio 1.08, haemoglobin 6.8 g/dl, platelet 312x 103/uL,
total white cell 7.97 x 10 9/L, calcium 2.44 mmol/L,
phosphate 2 mmol/L, and e1ythrocyte sedimentation rate
(ESR) 100 mm/hr. Urine microscopy shows 1 + protein,
no REC presence and urine protein creatinine index of
12.9g/day. Immunology screening revealed nonnal ANA,
C3, C4, and ANCA. Kidney ultrasound shows a left
kidney size of 10.3cm, and right kidney of 11.7cm with
preserved cmticomedullary differentiation bilaterally.
She was initially diagnosed with ESKD, and long-tenn
kidney replacement therapy was planned for her. |
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