To preserve patient privacy and for didactic purposes, case descriptions and pathology reports have been anonymized and partially fictionalized. The pathology images are representative images from a mixture of similar cases.
Jonathan SlaterCase Presenter | Baystate Medical Center, Springfield, MA, USA | No conflict of interest reported
Stewart LeckerNephrology Discussant | Beth Israel Deaconess Medical Center, Boston, MA, USA | No conflict of interest reported
The patient is a 65-year-old female with idiopathic nonalcoholic cirrhosis and longstanding DM, who was seen by Hematology for low platelets of 100.000. At that visit, laboratory data also noted new acute kidney injury with a serum creatinine of 4.5 mg/dl (up from a baseline of ⅙ mg/dl). The patient was admitted to the hospital for workup and evaluation, which was unrevealing.
During the hospital course creatinine decreased to 3.5 mg/dl which was in the setting of discontinuation of lisinopril.
Medical history: Diabetes mellitus type 2, HTN, metabolic syndrome, idiopathic nonalcoholic liver cirrhosis