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A 64-year-old man was admitted to the hospital because of abdominal pain, nausea, and an elevated level of serum creatinine. The patient had been in his usual state of health until 4 months before admission, when he was admitted to this hospital for 10 days because of abdominal pain. Acute pancreatitis and gastritis due to Helicobacter pylori were diagnosed. His symptoms diminished minimally after treatment with amoxicillin, metronidazole, and a proton-pump inhibitor and a shift to a bland diet. During the next 2 months, he was evaluated repeatedly by gastroenterologists, visited the emergency department multiple times because of abdominal pain,
Differential Diagnosis
Prerenal Azotemia
Postrenal Acute Kidney Injury
Intrinsic Renal Disease
Acute Renal Failure and Pancreatitis
Acute Interstitial Nephritis Due to Proton-Pump Inhibitors
Nephropathy Due to Oral Sodium Phosphate Solution
Clinical Diagnosis
Dr. Theodore I. Steinman's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Renal Division, Beth Israel Deaconess Medical Center (T.I.S.); the Departments of Radiology (A.E.S.) and Pathology (L.D.C.), Massachusetts General Hospital; and the Departments of Medicine (T.I.S.), Radiology (A.E.S.), and Pathology (L.D.C.), Harvard Medical School — all in Boston.
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