title: A rare cause of anuria: Bilateral synchronous isolated mid-ureteric tubercular lesions.
abstract: A young female presenting with right flank pain, fever, raised creatinine and bilateral hydronephrosis was treated with antibiotics elsewhere, with presumptive diagnosis of bilateral pyelonephritis. She had partial relief in symptoms and her creatinine level showed an improvement. Three months later during evaluation at our center she had anuria, hypertensive crisis and pulmonary edema which were managed with emergency bilateral percutaneous nephrostomies. Cross-sectional imaging and ureteroscopy suggested bilateral synchronous intramural mid-ureteric lesions as underlying pathology. Histopathology of the ureteric segments during laparotomy revealed caseating granulomas suggestive of tuberculosis. This clinical presentation has not been previously described in urinary tuberculosis.
authors.affiliation: Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Anuj D
authors.initials: AD
authors.lastname: Dangi
authors.affiliation: Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Thomas Alex
authors.initials: TA
authors.lastname: Kodiatte
authors.affiliation: Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Nitin S
authors.initials: NS
authors.lastname: Kekre
keywords: Anuria; synchronous; tuberculosis; ureteric stricture