Reviewing your ABCs - Acute Kidney Injury, Bartonella Endocarditis, and C-ANCA Vasculitis

A 67-year-old man presented to the emergency department with epistaxis, pancytopenia, and renal failure (creatinine, 633 umol/L; normal, 52-112 umol/L). He was recently diagnosed with cytoplasmic-antineutrophil cytoplasmic autoantibody (c-ANCA)-associated glomerulonephritis. Three weeks earlier, he presented with new-onset renal failure (creatinine, 738 umol/L), hyperkalemia (6.2 mmol/L; normal, 3.5-5.0 umol/L), and normocytic anemia (hemoglobin, 91 g/L; normal, 130-170 g/L). Urine microscopy revealed red blood cell and heme granular casts, concerning for rapidly progressive glomerulonephritis.

Source: The American Journal of Medicine - October 31, 2023 Category: General Medicine Authors: Tina B. Marvasti, Rohan Philip, Harsh Parikh, Elias Hazan, Peter Jianrui Liu, Omar Saeed, Maxime Billick Tags: Diagnostic Dilemma Source Type: research