A 79-year-old woman with hypertension presented with lower limb edema in June 2010.
Microscopic hematuria and proteinuria of 1,776 mg/24 h, NU 46.6 mg/dl, creatine 1.6 mg/dl, creatinine clearance 42 ml/min/1,73m2, enalapril albumin 6.8 gdl were prescribed.
Reappeared 7 months later (January 2011) in anas.
Urinary tract infection was diagnosed in 14 patients mg/24 h, proteinuria 4.7 g/dl, albuminemia 2.3 g/dl, creatinine 2.1 mg/dl, creatinine clearance 38.6 ml/min/1.73 m2) and hematuria.
The echotomography described a right kidney of 9.6 x 6.1 cm and the left kidney of 10.5 x 5.7 cm with diffuse increase in echogenicity and preserved corticomedullary differentiation.
Complement C'3 and C'4 were normal, viral serology (virus B, C, HIV) and autoimmunity (ANA, ANCA, ENA, antiDNA for proteins) were negative and were not detected.
Diuretics were prescribed and a renal biopsy was indicated.
In the hospitalization motivated to perform renal biopsy it was found that the renal function had worsened notoriously (creatinine 5.5 mg/dl, NU 66 mg/dl) so a catheter was started to perform hemodialysis.
One month later, anorexia nervosa and progressive weight loss made us suspect cancer.
CT scan showed a 3.3 cm hypodense image at the level of the cervix that was reinforced with the contrast medium and dilation of the endometrial cavity.
A transvaginal ultrasound showed a liquid-occupied uterine cavity that made a blood collection suspect.
Hysterectomy and bilateral adnexectomy were performed.
There was a lesion corresponding to the cervical canal and corresponding to an epidermoid carcinoma with permeation to the lymphatic glands.
Due to her poor general condition, the family decided not to undergo chemotherapy or radiotherapy.
Two months later, the dialysis catheter was infected and removed.
The SN persisted and there was a slight reduction in azotemia (creatinine 4.95 mg/dl, NU 72 mg/dl), so a new dialysis catheter was temporarily suspended before instalation.
In July 2011, there was improvement in renal function (creatinine 1.77 mg/dl, creatinine clearance 30.2 ml/min/1.73m2) and partial remission of nephrotic syndrome 229 mg/2446 cholesterol (proteinuria 1.603 mg).
In the following months, proteinuria continued to recur and in the last follow-up visit 2012 the patient was asymptomatic and the NS was in complete remission.
