News  |  Journals  |  Conferences  |  Blogs  |  Articles  |  Forums  |  Twitter   
 

 Headlines:

 
 

Doctors Lounge - Nephrology Answers

"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."

Back to Nephrology Answers List

Forum Name: Glomerulonephritis

Question: Possible Glomerulonephritis


 jmanqr - Wed Mar 07, 2007 11:38 pm

My mother is white, 65 yo woman with a history of HTN managed by ACEI (Altace) and hyperthyroidism (now normal) that has had left flank and left mid back pain since May of 2006. In June 2006 she had a urinary tract infection which was treated with bactrim. However, this intensified the pain. She stopped taking the antibiotic and her acute pain lessened. Her left side pain has increased gradually over the insuing months. Her right mid back has now begun to hurt as well although not as bad as the left. She describes her left side pain as extreme soreness with occassional sharp, stabbing bursts which can wake her from sleep with SOA. She has had abdominal MRI and cardiolite stress test in the last two months that were unremarkable. She recently went to the ER when advised by her immediate care center during one of her flares ups.

Her blood test revealed the following: (2/11/07)
Occult blood 1.0 + abnormal
epithelial cells 5-10 abnormal
D-dimer 564 abnormal
CO2 33 slightly high (end of normal 32)
K+ 3.4 slightly low (3.5-5.0)
Cl- 95 low (end of normal 100)
Folic acid 20 abnormal (3.3-12.4)
Neutrophils 79.1 slightly high (49-79)
BUN 19
creatinine 0.8
BUN/creatinine ratio 23.8

The chronic pain makes it difficult to sleep and she is getting frustrated with the various physicians/NPs that have not seemed to diagnose/treat the problem. Lately, she has felt a general malaise and fatigue with occassional +1 pedal edema at night. She occassionaly complains of leg pain as well.

It seems to me that she has a clinical presentation of glomerulonephritis or pyelonephritis. Could there be any other possible diagnoses likely, for example abdominal arotic aneurysm?

If is renal what can be done to help relieve the pain?

Thanks
 Dr. Chan Lowe - Thu Mar 08, 2007 3:05 pm

User avatar There are a few possibilities of your mother's pain. The blood in her urine may be due to infection that has not cleared or possibly kidney stones. I would tend to favor kidney stones over infection as generally infections going on for that long would be quite severe and have other symptoms of fever and dysuria.

Her electrolytes are essentially normal. I would not be concerned about these. Her kidney function appears to be normal based on her creatinine and BUN.

I would recommend a few tests. 1) A complete urinalysis and culture to assess for infections. 2) a spot calcium/creatitine urine test to look for elevated urine calcium which can cause blood/pain even without overt kidney stones. 3) If the pain continues to be severe a renal ultrasound may be helpful but the best test for kidney stones is a CT scan.

Continued follow up with her doctor is important. She may also want to see a kidney specialist or urologist to help guide the work up.

Hope this helps.

|

Check a doctor's response to similar questions

 

advertisement.gif (61x7 -- 0 bytes)
 

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

 
     

 advertisement.gif (61x7 -- 0 bytes)

 

 

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us

 
Copyright © 2001-2010
Doctors Lounge.
All rights reserved.

Medical Reference:
Diseases | Symptoms
Drugs | Labs | Procedures
Software | Tutorials

Advertising
Links | Humor
Forum Archive
CME Articles

Privacy Statement
Terms & Conditions
Editorial Board
About us | Email

We subscribe to the HONcode principles of the HON Foundation. Click to verify.We subscribe to the HONcode principles.
Verify here