Diagnose This #17

Hey guys, and welcome back to Diagnose This! Been another hectic week, so let’s get straight to it:

The type of kidney condition occurring in this patient is a nephrotic syndrome, shown by the oedema and massive proteinuria. The rare condition causing this is amyloidosis; the deposition of amyloid proteins either systemically or in various organs around the body (in this case, the kidneys.) The specific classification of this patient’s condition is primary systemic amyloidosis, with the diagnostic urine immunofixation providing the clinching diagnosis. A differential diagnosis to definitely consider though is multiple myeloma: please don’t forget this in these patients!

Now, onto the next case friends:

A patient presents to the ED complaining of sudden, tearing chest pain extending to his back. On examination he appears sweaty, pale, and in quite a considerable amount of pain. His BP is 185/100 and 100/60 left/right respectively and his heart rate is 110bpm. ECG comes back normal, and troponins are negative. An urgent CT is performed:

 

13090506_10154798878629278_82167510_n

Case courtesy of Dr Jeremy Jones, <a href=”http://radiopaedia.org/”>Radiopaedia.org</a&gt;. From the case <a href=”http://radiopaedia.org/cases/6264″>rID: 6264</a

What is your diagnosis? Is this an urgent problem? How would you treat this patient, and what are his chances of survival?

 

Tune in next week for Diagnose This!

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