case_images: PMC8367082_01
case_images: Variation of hemoglobin and creatininemia over the last 3 months.
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case_images: Over three months of outpatient follow-up, he had four sets of renal labs drawn, and all showed impaired renal function (Figure 1). During the same period, he had four altered blood counts showing severe anemia that did not correct (Figure 1), and the last of these revealed a severe microcytic hypochromic anemia with a hemoglobin level of 7.4 gr/dl, MCV at 79.2 fl. and a MCHC at 26.6 pg, and hyperleukocytosis of 15,800 with neutrophilic predominance (76%). During his stay on the unit, he received 31 sessions of hemodialysis and 9-unit bags of compatible packed red blood cells that did little to correct his anemia (Figure 1).
case_images: Ultrasound of the kidneys (L: left; R: right).
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case_images: He also had an abdominal pelvic ultrasound showing poor cortico-medullary differentiation with small kidneys (right kidney 9.7*5.02 cm; left kidney 9.7*5.6 cm) and dilatation of the pyelocaliceal system and proximal ureter (Figure 2).
case_images: Identification of the testicles (in the inguinal region), ovaries and the empty srotum on abdominal-pelvic ultrasound.
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case_images: Bilateral cryptorchidism is also described in the inguinal region (right testicles 2.7*1.1 cm and left 1.37*1.04 cm), and presence of functional ovaries (1.6*1.1 cm on the right and 1.5*1.7 cm on the left) with follicles of variable size scattered in the parenchyma (Figure 3).