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Abdominal pain, rib tenderness, stiff back, protein in urine, abnormal ESR. Are my kidneys damaged?

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I'm a 32 year old female and I haven't been feeling well for the past several months. My recent report shows:

1. Protein in urine

2. Abnormal ESR

3. I got an abdominal ultrasound and it came back with an area of hypodensity in the left lobe of my liver and it was 3 cm wide. They said that they could not determine what it was in the ultrasound.

4. Urine culture, ultrasound ovaries and uterus normal, kidneys were normal, as was gallbladder. I had blood tests done and the only abnormal finding was an ESR of 30 and my doctor said it was an indication of inflammation. Liver and kidney functions were normal.

I've been experiencing pain in my upper right abdominal area, as well as a lot of tenderness in my ribs on the right side of my body. They are tender to the touch. I often feel pressure and pain under my right ribs. I have also been experiencing stiffness around my spine in the middle of my back. It is a pulling sensation, like a pressure. It is getting uncomfortable to sleep at night. I've experienced neck pain and stiffness in my neck for years, but have never experienced any problems in my back before!

My doctor is sending me for a repeat ultrasound, CAT scan, X-Ray of my spine. Also for medication, I'm currently on Propranolol 30mgs. twice a day. Any advice you can give is much appreciated! Are my kidneys damaged? What do all these findings together say?

Here is my medical history in brief:

I have some heart issues since age 24. Have high resting heart rate of over 100 and have been experiencing series of skipped beats. A holter monitor last year found PVCs on the recording. I also have a history of bladder infections and sleep problems.Some lab tests done last year showed:

1. Raised urine creatinine levels (don’t have exact levels)

2. High random cortisol (581 nmol/L)

3. High aldosterone (1017 pmol/L)

4. Renin was normal (1.10 ng/L/S). Everything else was normal.
I ran out of space, but my doctor is sending me back to do the ultrasound again of my liver and kidneys and if it is still inconclusive, she will send me for a CAT scan. She is also sending me for an X-Ray of my spine which I plan on doing in the next few days. Also for medication, I'm currently on Propranolol 30mgs. twice a day (if you read the background post I linked to, you will see why I'm on this medication). Any advice you can give is much appreciated! Are my kidney's damaged? What do all these findings together say?
Posted Thu, 12 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Shanthi.E 3 days later

I understand your health concern and I appreciate your efforts to put in details of your history with the investigation reports. Thank you again.

The current health issue you are facing may be simplified so that you understand it in a better and easier way. I will suggest you on this.

It is good to know that most of your reports are normal. Let me explain it to you in a simpler way.

Presence of protein in urine in your case may be regarded as a response to an acute infection and may be brushed aside. It may as well be regarded as a temporary finding and may not signify anything at all. Perhaps repeating urine protein levels along routine urine analysis as well as serum creatinine, urine protein/creatinine ratio will help us determining kidney status better.

However in your case, I feel the area of hypodensity in the left lobe of liver is the one which needs primary concern now. The high ESR, Pain in your ribs and your back, may all be related to the liver issue.

So, go ahead with the repeat Ultrasound to find out the exact cause and to confirm the diagnosis of this hypodense area. Once this issue is resolved, I think your ESR will become normal and your bone pain will reduce.

This hypodense area in the liver can be just an infection, an hydatid cyst or even a tumor in the liver. A detailed ultrasound and sampling of the area is required to conclude on the diagnosis. But, once this is treated, you will be absolutely fine.

The heart problem and the current health issue are not related to each other at all.

Yes, Alcohol consumption definitely has an effect on the liver. You need to discontinue this.

There is a possibility of Pheochromocytoma in you. Kindly get evaluated by an endocrinologist regarding the same.

Hope my suggestions will help you. I will be available for your follow up queries if any.

Get well soon.


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