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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:951-958 April 1, 1993 Number 13
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Case 13-1993— A 74-Year-Old Woman with Rapidly Progressing Renal Failure after an Upper Respiratory Tract Infection
Julian L. Seifter, John L. Niles, and Robert T. McCluskey

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Presentation of Case

A 74-year-old woman was admitted to the hospital because of progressive renal failure.

The patient had had a subendocardial infarct and congestive heart failure 14 months before admission. Nine months before entry she was treated as an inpatient for congestive heart failure. An echocardiographic study revealed appreciable mitral regurgitation. Six months before admission she underwent sigmoidoscopic examination, which showed diverticulosis and a colonic polyp, which was removed. The urea nitrogen was 18 mg per deciliter (2.9 mmol per liter), and the creatinine was 1.1 mg per deciliter (97.2 µmol per liter).

Thereafter, the patient was in stable health until 12 . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Julian L. Seifter's Diagnosis

Pathological Discussion

Anatomical Diagnosis

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