Thursday, December 30, 2010

Case of gross hematuria following a game of soccer

A 37 year old male complains of gross hematuria following a game of soccer with his friends at work. He could not recall any particularly severe trauma. On examination both kidneys were enlarged and easy palpable. His blood pressure was raised. A likely diagnosis is :

a) polycystic disease of the kidneys
b) Berger's nephritis
c) systemic lupus erythematosus
d) renal vein thrombosis
e) Goodpasture's syndrome

The correct answer is...................... A

In polycystic disease of the kidneys the symptoms or signs first occur between the third and fourth decades of life. These include microscopic and gross hematuria, flank pain and hypertension. The polycystic condition is not confined to the kidneys. Hepatic cysts, usually identified incidentally by sonography, help in making the diagnosis of DPK. These cysts are more likely to be found in adults than in children. Approximately 10% to 40% of patients have berry aneurysms, and approximately 9% of these patients die because of subarachnoid hemorrhages

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