A 38 year old female, MM, is seen in your office complaining of malaise for the past several months, a chronic cough , and pain in the left flank with hematuria . There is no medical history of note. There is no recent travel; she is afebrile, a nonsmoker, and not on any medication. There is a family history of kidney stones , but her diet is not particularly rich in proteins , oxalates or dairy products. Routine chest radiograph and blood work/urinalysis was ordered. The report from the laboratory shows increased serum/urinary calcium concentration and urinary red blood cells, and an enlargement of the lymph nodes where the blood vessels and nerves enter the lung is evident on the radiograph. Otherwise the blood work is normal, including serum/urinary urate levels. Urate elevation is a common cause of stone formation with genetically linked altered purine metabolism.
Asked On : Fri, 21 Dec 2012