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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 343:870-877 September 21, 2000 Number 12
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Case 29-2000— A 69-Year-Old Renal-Transplant Recipient with Low-Grade Fever and Multiple Pulmonary Nodules
Mark S. Drapkin, and Eugene J. Mark

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Presentation of Case

A 69-year-old woman was admitted to the hospital because of weakness, cough, and low-grade fever.

The patient had end-stage renal disease due to membranous glomerulonephritis (Figure 1 and Figure 2) and a long history of hypertension. Four years before admission, after having undergone extracorporeal hemodialysis for three years, she received a cadaveric renal transplant, which was rejected because of the development of focal segmental glomerulosclerosis. Transplantation of a second cadaveric kidney was performed 34 months before admission. There were no episodes of rejection, and the creatinine level was approximately 2 mg per deciliter (180 µmol per liter). A . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Mark S. Drapkin's Diagnoses

Pathological Discussion

Anatomical Diagnosis

References




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