A 14-year-old patient presented with fatigue or fatigue, tremors, with 15 days of evolution.
There was no history of fever, only morning cramps in lower limbs the previous days.
Until then he danced several days a week and had a very active life.
Family from Chile.
The child was born in New York and lives in Spain for 6 years.
Unworthy personal history.
Right vaccines.
No known drug allergies.
No remarkable diseases in childhood.
Menarche 2 years ago.
Family history: family member with Berger's disease pending kidney transplantation.
Physical location: weight 51 kg; height 160 cm; TA 120 mmHg; heart rate 105 beats/minute; axillary temperature 36.8oC.
Good general condition, pale skin and mucous membranes (rubia), no skin lesions.
Small submandibular adenopathies.
Normal neurological condition; normal cardiorespiratory apparatus; abdomen without any evaluable finding, no visceromegaly, negative lumbar percussion wrist; correct hydration.
Analytical results
- Hemoglobin of 10.3 g/dl; neutrophils 67 3.880.000; hematocrit 29.7; MCV 77; leukocyte formula: 11,100 leukocytes with 63.2% neutrophils, 25.1% lymphocytes/eosinophils; bas lymphocytes 0.5%.
- Glucose of 93 mg/dl with normal glycosylated haemoglobin; creatinine: 1.15 mg/dl; total cholesterol: 114 mg/dl; ferritin 133 mcg/l; sideremia 17 mcg/dl
Under suspicion of renal failure7,8 he was admitted to the hospital.
Renal ultrasound: symmetrical but significantly large kidneys; no dilatation of collecting systems, normal Doppler and normal echogenicity.
Renal balance: FG (T) 70.67 ml/min/ 1.73 m2; FG (SC) 50.02 ml/min/ m2.
Proteinuria 20.71 mg/m2/hour.
Diagnosis: mild to moderate renal failure with proteinuria without hematuria.
Anatomopathological diagnosis: tubulointerstitial nephritis with acute tubular damage (probably secondary to infectious process/drugs).
