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A 62-year-old man was admitted to the hospital because of bilateral epistaxis and orthostatic hypotension. He had a long history of hypertension treated with lisinopril. Gout of five years' duration was suppressed by allopurinol. A left renal-cell carcinoma had been managed by a radical nephrectomy five years before entry. Although the patient felt well, evaluation 7 1/2 weeks before admission showed + proteinuria and 2 red cells and 8 white cells per high-power field. Cytologic examination of a urine specimen was negative. The serum creatinine was 1.6 mg per deciliter (140 µmol per liter). The level of prostate-specific antigen was
Differential Diagnosis
Clinical Diagnosis
Dr. Kenneth C. Anderson's Diagnosis
Pathological Discussion
Anatomical Diagnosis
References
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