A young man with polyuria and lethargy.

Abstract

We report a 20-year-old man who presented to our emergency room with a history of polyuria, weakness, constipation, nausea, and vomiting of two months duration. History and clinical examination revealed a significant weight loss and mild hepatomegaly. Laboratory investigations revealed hypokalemia, hypernatremia, and severe metabolic acidosis and anemia. Ultra-sound of the abdomen revealed enlarged kidneys without hydronerphrosis. The patient developed paralysis due to further decline in serum potassium level, which improved after an aggressive fluid and electrolyte management. He was investigated extensively for polyuria and type of acidosis. The kidney biopsy showed interstitial leukemic infiltration. He was managed accordingly and recovered from the condition. This case demonstrates an unusual presentation of a hematological malignancy, which was a diagnostic as well as a management challenge.

• Authors: Salman Imtiaz, Shahid Qayyum, Hala Kafouri, Habib ur Rehman, Mohammad Al Khoiter, Akram Askar
• Journal: Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (Saudi J Kidney Dis Transpl) Vol. 22 Issue 4 Pg. 847-52 (Jul 2011) ISSN: 1319-2442 [Print] Saudi Arabia
• PMID: 21743247 (Publication Type: Case Reports, Journal Article)

Topics

• Diagnosis, Differential
• Humans
• Kidney (pathology)
• Kidney Neoplasms (complications, diagnosis, secondary)
• Lethargy (diagnosis, etiology)
• Magnetic Resonance Imaging
• Male
• Polyuria (diagnosis, etiology)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, pathology)
• Tomography, X-Ray Computed
• Young Adult