| Case 44 3/19/99 Patient |
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| Case discussion This 23 year-old man, a roofer, was hospitalized for acute renal failure. His acute illness began when he and a co-worker attempted to lift a 200 pound water heater. He developed a severe left leg cramp that lasted two hours. Approximately six hours later he voided dark urine, the color of ‘coca cola’. He passed no urine for two days, gained five pounds, and began to vomit. Serum creatinine rose to 16.3, BUN 84 and creatine kinase 44,000. He was dialyzed twice and began to void one week later. This was the fourth episode of dark urine he had suffered over seven years, each following mild to moderate exertion. Exercise intolerance and muscle cramps throughout adolescence had interfered with sports. There is no family history of similar problems. Physical examination, including repeated deep knee bends, was normal. Pathologic Case Correlate: Neuropath Case 12 |