Images in Clinical Medicine
A Hearty Finding
N Engl J Med 2007; 356:714February 15, 2007
- Article
A 54-year-old man presented to the emergency room with a 1-week history of influenza-like symptoms. He had undergone renal transplantation 12 years earlier for diabetic nephropathy. Laboratory evaluations were notable for an increase in his serum creatinine level to 6.0 mg per deciliter (530 μmol per liter) and 3+ proteinuria. Because of worsening renal failure, a renal biopsy was performed, which showed moderate chronic allograft nephropathy. In addition, an incidental finding of a heart-shaped, attenuated proximal renal tubule was seen. The influenza-like symptoms resolved within 2 weeks; however, the renal failure progressed, and the patient is once again being treated with dialysis.
Marie E. Peddinghaus, M.D.
Nedjema Sustento-Reodica, M.D.
Hahnemann University Hospital, Philadelphia, PA 19102
marie.peddinghaus@drexelmed. edu
