Dr. Mahmoud Ahmed Abdelrahman Abouibrahim
Internal Medicine
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Patient's Query
Hello doctor,
Flank pain about nine weeks. Medullary sponge kidney calcification of kidney, past lung pneumothorax four times. Sinusitis surgery six times. No urine or blood infection. Normal kidney function. Chest pain sometimes. Fatigue, diarrhea only morning. Initial signs of clubbing. Currently, I am on Symbicort and Avamys.
Hi,
Welcome to icliniq.com.
The features of the ultrasound are of medullary sponge kidney which is a genetic disease with one in every 20000 affection. Although the condition is progressive, the kidney functions will be preserved for a long time. Urine gravels, stones, and infections are common that is why there is a flank pain. Hyperparathyroidism is common and should be excluded by measuring the parathormone level in blood. The lung condition and sinusitis suggest associated autoimmune condition, so autoimmune profile should be performed. Churg-Strauss disease may be associated which cause asthma, sinusitis, and renal affection. My advice to you is to drink plenty of fluids, CT (computerized tomography) KUB (kidney, ureter, and bladder) to exclude any renal stones. I suggest you take Tramadol 200 mg extended-release tablet for the pain, Parathormone level to exclude hyperparathyroidism, P. Anca (perinuclear anti-neutrophil cytoplasmic antibodies) and ANA (anti-nuclear antibody) test to detect associated auto-immuneconditions. Repeat renal functions every six months. Also I suggest you Renal biopsyshould be performed in order to confirm the diagnosis.Your case requires further investigations and assessment to reach the appropriate decision. Thank you and take care. Regards.
Patient's Query
Thank you doctor,
So the kidney condition is progressive. Can this be slowed down? And what will the final progress be? What is Hyperparathyroidism? Once if I do the renal biopsy and the condition is confirmed, what benefit and treatment can it be done? If there is no treatment then what is the use for the biopsy? Can there be no problem with the medullary sponge kidney? But is there a chance? Maybe it can be cancerous? Or pain coming from lungs of other organs?
Hi,
Welcome back to icliniq.com.
Medullary sponge kidney is a completely benign condition with very slow progression, only 10 percent develop kidney insufficiency. The most important element is to treat urinary infection and renal stones if present. Hyperparathyroidism is a common association which causes elevated hormone called parathormone (secreted from parathyroid gland) which cause hypercalcemia. The condition is completely benign with no cancerous transformation. Renal biopsy is the last option in order to exclude any other cause. I need to see your CT (computerized tomography) scan. Kindly revert back. Thank you and take care. Regards
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Internal Medicine
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