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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 342:264-273 January 27, 2000 Number 4
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Case 3-2000— A 66-Year-Old Woman with Diabetes, Coronary Disease, Orthostatic Hypotension, and the Nephrotic Syndrome
Thomas G. DiSalvo, Mary Etta King, and R. Neal Smith

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Presentation of Case

A 66-year-old woman was admitted to the hospital because of the nephrotic syndrome.

For 30 years, she had had hypertension related to fibromuscular dysplasia of the right renal artery. A saphenous-vein bypass graft had failed, resulting in a poorly functioning right kidney. Angina pectoris developed 24 years before admission. Diabetes mellitus was discovered seven years later and was successfully managed with insulin therapy. Five years before admission, the urea nitrogen level was 34 mg per deciliter (12 mmol per liter), and the creatinine level was 1.3 mg per deciliter (114.9 µmol per liter). Coronary-artery bypass grafting was performed two and . . . [Full Text of this Article]

Differential Diagnosis

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Dr. Thomas G. DiSalvo's Diagnosis

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Related Letters:

Case 3-2000
Boyne M.
Extract | Full Text  
N Engl J Med 2000; 343:70-71, Jul 6, 2000. Correspondence

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