Lymphadenopathy and proteinuria (original) (raw)

2004, Nephrology Dialysis Transplantation

A 79-year-old Vietnamese woman was hospitalized with a 2-month history of progressive fatigue and dyspnoea. Her past history included hypertension, hypercholesterolemia and cholecystectomy. Her physical examination revealed dyspnoea at rest, bilateral crepitus, ascites, peripheral leg oedema, hypertension (150/100 mmHg), ecchymosis, left subconjunctival haemorrhage jugulo-carotidian and axillary lymphadenopathies and barely palpable liver and spleen.

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Pathologic Quiz Case: A 72-Year-Old Man With Fatigue and Proteinuria

Archives of Pathology & Laboratory Medicine, 2003

A 72-year-old white man with a medical history significant for dilated cardiomyopathy and chronic atrial fibrillation, hypothyroidism, and osteoarthritis presented to his primary care physician with fatigue, weight loss, and polyuria. Additional review of systems revealed a history of mild hypertension for which he was taking antihypertension medications. Physical examination was unremarkable. Laboratory evaluation revealed proteinuria with hyaline casts in the urine sediment. He was referred to a nephrologist for further work-up of his proteinuria. A quantitative urinalysis revealed proteinuria near the nephrotic range, with 2.8 g protein/24 hours. Blood urea nitrogen was 25 mg/dL, and serum creatinine was 1.1 mg/dL. Additional laboratory analyses revealed a normochromic, normocytic anemia with hemoglobin concentration of 8.8 g/dL and a hematocrit of 26.3%. White blood cell count was 4.4 ϫ 10 3 /L, with a differential of 69% polymorphonuclear leucocytes, 20% lymphocytes, 9% monocytes, 1% eosinophils, and 1% basophils. The platelet count was 230 ϫ 10 3 /L. Serum and urine protein electrophoresis showed a small lambda light-chain immunoglobulin spike. Antinuclear antibody titer, iron, folate, and B 12 levels were normal. Erythropoietin level was decreased relative to the degree of anemia. A renal biopsy was performed, and 3 cores of tan, rubbery tissue 0.9 and 1.0 cm in length by 0.1 cm in diameter were obtained. These specimens were entirely submitted

A 79 year old man with chronic lymphocytic leukemia and nephrotic syndrome

Internal and emergency medicine, 2012

Dr. Netti, Dr. Bruno A 79-year-old man was diagnosed with B-cell chronic lymphocytic leukemia (B-CLL) in another institution. During hospitalization, hematochemical examination revealed leukocytosis (30.8 9 10 9 cells/L) with inverted formula (neutrophils 26%, lymphocytes 64%) and chronic renal failure [serum creatinine 143.2 lmol/L; estimated glomerular filtration rate (eGFR), 54 mL/min/1.73 m 2 according to the modification of diet in renal disease (MDRD) study equation], while hemoglobin level and platelet count were normal. At physical examination, no painful disease-related overgrowth of lymph nodes or spleen was observed. Only a few percentage of peripheral blood lymphocytes showed an undifferentiated phenotype (\10%). Because of the low grade disease (B-CLL RAI 0, Binet A), no treatment was carried out.

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