title: [Progressive deterioration in an elderly patient].
abstract: Vasculitis is diagnosed with increasing frequency in the elderly. We hereby present the case of an 84-year-old male, who had weight loss, low-degree fever, anemia and epigastric pain. After 14 days of study with the tentative diagnosis of digestive neoplasia, a progressive renal insufficiency was detected. This clinical picture was secondary to ANCA-positive vasculitis. The case poses the differential diagnosis of non-oliguric acute renal failure (FRA) in elder people and the systematics of the study of renal insufficiency in individuals with previously unknown renal function. Also, this patient's history emphasizes the importance of acute deterioration of renal function as a guiding symptom for orienting the interpretation of clinical data. In the present case, a diagnostic hypothesis based only in the pursue of an occult digestive tumor misguided the attention from the main cause of the disease.
authors.affiliation: Servicio de Nefrología de la Fundación Jiménez Díaz, Madrid.
authors.forename: R
authors.initials: R
authors.lastname: Melero
authors.forename: M
authors.initials: M
authors.lastname: Adrados
authors.forename: I
authors.initials: I
authors.lastname: Fuentes
authors.forename: R
authors.initials: R
authors.lastname: Carrillo
authors.forename: J
authors.initials: J
authors.lastname: Casado
authors.forename: J
authors.initials: J
authors.lastname: Hurtado
authors.forename: C
authors.initials: C
authors.lastname: Caramelo
authors.forename: J
authors.initials: J
authors.lastname: Martín
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D000747:Anemia, Hypochromic / Q000209:etiology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic