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Previous Volume 358:827-838 February 21, 2008 Number 8 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Nancy Cibotti-Granof (Medicine): A 46-year-old woman with end-stage renal disease was seen by a rheumatology consultant because of stiffness of her joints and skin.

The patient had been well except for mild asthma until 7 years earlier, when group A streptococcal pneumonia developed, complicated by septic shock, with acute respiratory distress syndrome; septic emboli to the lungs, brain, and kidney; renal failure requiring dialysis; flaccid quadriplegia; and coma. On the 25th day after initial admission to another hospital, she was transferred to this hospital while she was receiving mechanical ventilation.

As part of the evaluation during admission, computed tomography . . . [Full Text of this Article]

Differential Diagnosis

Peripheral Neuropathy

Respiratory Failure

Granulomatous Pulmonary Disease

Congestive Heart Failure

Amyloidosis

Fibrosing Disorders

Beta₂-Microglobulin Amyloidosis

Nephrogenic Systemic Fibrosis

Dr. Jonathan Kay's Diagnosis

Pathological Discussion

Discussion of Management

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Department of Medicine, Division of Rheumatology, Allergy, and Immunology (J.K.), and the Departments of Nephrology (H.B.), Radiology (L.L.A.), and Pathology (A.F.K.), Massachusetts General Hospital; and the Departments of Medicine (J.K., H.B.), Radiology (L.L.A.), and Pathology (A.F.K.), Harvard Medical School.

This article has been cited by other articles:

• Heher, E. C., Thier, S. O., Rennke, H., Humphreys, B. D. (2008). Adverse Renal and Metabolic Effects Associated with Oral Sodium Phosphate Bowel Preparation. CJASN 3: 1494-1503 [Abstract] [Full Text]