title: A young man with polyuria and lethargy.
abstract: We report a 20-year-old man who presented to our emergency room with a history of polyuria, weakness, constipation, nausea, and vomiting of two months duration. History and clinical examination revealed a significant weight loss and mild hepatomegaly. Laboratory investigations revealed hypokalemia, hypernatremia, and severe metabolic acidosis and anemia. Ultra-sound of the abdomen revealed enlarged kidneys without hydronerphrosis. The patient developed paralysis due to further decline in serum potassium level, which improved after an aggressive fluid and electrolyte management. He was investigated extensively for polyuria and type of acidosis. The kidney biopsy showed interstitial leukemic infiltration. He was managed accordingly and recovered from the condition. This case demonstrates an unusual presentation of a hematological malignancy, which was a diagnostic as well as a management challenge.
authors: King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. salman_imtiaz@hotmail.com
authors: Salman
authors: S
authors: Imtiaz
authors: Shahid
authors: S
authors: Qayyum
authors: Hala
authors: H
authors: Kafouri
authors: Mohammad
authors: M
authors: Al Khoiter
authors: Akram
authors: A
authors: Askar
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D053609:Lethargy / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011141:Polyuria / Q000175:diagnosis / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult