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Case Records of the Massachusetts General Hospital
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Volume 357:1531-1541 October 11, 2007 Number 15
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Case 31-2007 — A 41-Year-Old Man with Abdominal Pain and Elevated Serum Creatinine
Hamid Rabb, M.D., and Robert B. Colvin, M.D.

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Presentation of Case

A 41-year-old man was admitted to this hospital because of abdominal pain, nausea, and an elevated serum creatinine level. He had been in good health until 6 days before admission, when chills and malaise developed. At that time, his body felt warm to the touch, but the temperature was not measured. He took ibuprofen (at a dose of 400 mg) orally every 6 hours for three or four doses, with some improvement in his symptoms. Weakness and nausea developed, and he took one dose of an over-the-counter medication that included acetaminophen, dextromethorphan, and pseudoephedrine, with improvement in his symptoms.

Two . . . [Full Text of this Article]

Differential Diagnosis

Acute Kidney Injury

            Tubulointerstitial Causes

            Glomerular Causes

Urinalysis

NSAIDs

Clinical Diagnosis

Dr. Hamid Rabb's Diagnoses

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Nephrology Division, Johns Hopkins Hospital, and the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore (H.R.); and the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (R.B.C.).


Related Letters:

Case 31-2007: A Man with Abdominal Pain and Elevated Creatinine
Haas C. S., Devarajan P., Parikh C., Barasch J., Kleeman F. J., Rabb H., Colvin R. B.
Extract | Full Text | PDF  
N Engl J Med 2008; 358:312-313, Jan 17, 2008. Correspondence

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