Case 1-1981

Presentation of Case First admission. A 53-year-old woman was admitted to the hospital because of subarachnoid hemorrhage.She was well until seven months earlier, when she began to experience polyuria and polydipsia, and azotemia was found. Two months later hypertension was discovered. A percutaneous renal biopsy revealed widespread interstitial fibrosis and tubular atrophy, with a moderate infiltration of mononuclear cells and occasional eosinophils (Fig. 1). The tubular lining cells were flattened, and there was marked thickening of the tubular basement membranes; many tubules contained proteinaceous casts. Examination of the 30 glomeruli sampled disclosed a moderate increase in mesangial matrix . . .