ADYNAMIC OSTEOPATHY: ABOUT A CASE WITH REVIEW OF THE LITERATURE

We report the case of a 42-year-old housewife patient whowasadmitted for impairedrenalfunction at 1246 μmmol/l with a clearance of 3.07ml/min/1.73m2, with the aim of to show a rare case of adynamicosteopathy with review of the literature. The clinical examination on admission hadfound a patient altered, impotent, pain in bothlowerlimbs, dehydrated, pale, BP=170/90mmhg, temperature at 36°7, heart rate at 100bts/min. Biologically:anemiawasfound at 7.2 g/dl. Hyperleukocytosis at 15400/mm3. Creatininewas 1246 µmol/l, urea 49mmol/l, uricacid 850umol/l, parathormone 58.4 pg/l and vitamin D 16 ng/l. The reprovedcalcemiawas at 2.73 mmol/l, the phosphorus at 2.69 mmol/l, the bicarbonateemia at 13 mmol/l. Blood sugarwas 6.1mmol/l, ferritinemia 1800 ng/ml, Na+=137mmol/l, K+=4.3 mmol/l, Cl-=106 mmol/l, proteinuria 6.8g/24 hours ,leucocyturia at 40000/mm3, withouthaematuria, an E.coliurinary tract infection whichwas sensitive to ciprofloxacin. Our patient had a heterozygous AC sickle cell profile, and wascarrying an evolving single-fetalpregnancy of 15 weeks +5 days on ultrasound. On the cerebral scanner, wefound a semi-recentischemic stroke in the deepterritory of the left middle cerebralartery. The patient alsounderwent five hemodialysis sessions. A biological control aftertwomonths of treatment hadfoundserumcreatinine at 212 µmol/l, urea at 40.3 mmol/l, sodium at 132.9 mmol/l, serum potassium at 5.2 mmol/, bloodchloride at 91.6 mmol/l, Magnesium at 1.1mmol/l, serum calcium=3.1mmol/l, CRP at 21mg/l, White Blood Cells at 1200/mm3, Hemoglobinlevel at 6.6 g/dl. The VS was at 90-100 mm.Urinary volume at 680ml. Adynamic osteopathyis a rare and fatal pathologythatrequiresearly treatment.