
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Oliguria with fatigue, somatic pain, vomiting, and diarrhea
Introduction
Abbreviations: ABG = Arterial blood gases, BUN = Blood urea nitrogen, CBC = Complete blood count, CT = Computed tomography, CRP = C – reactive protein, ECG = Electrocardiogram, ESR = Erythrocyte sedimentation rate, IVP = Intravenous pyelography, KFT = Kidney function test, GI = Gastrointestinal, GFR = Glomerular filtration rate, MRI = Magnetic resonance imaging, PT = Prothrombin time
| Etiology | Clinical manifestations | Paraclinical findings | Comments | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms and signs | Lab findings | Imaging | ||||||||||||||||||||
| Fatigue/
Lethargy |
Thirst | Dizziness/
Confusion |
Muscle weakness/
cramp |
Somatic/
visceral pain |
Vomiting | Diarrhea | Tachypnea | Edema | Blood indices | Renal Funtion test | Electrolytes | Urine analysis | ABG | Other | Ultrasound | X-ray | CT | MRI | Other | |||
| Prerenal causes | Alcohol poisoning[1][2] | + | – | +/- | – | +/- | + | +/- | – | – | βPT | βBUN, βCr (isopropyl alcohol) | βNa | Not applicable | βHCO3 | LFT | Not applicable | Not applicable | Not applicable | Not applicable | – | Thiamine must be given to prevent Wernicke’s encephalopathy |
| Drugs/toxins[3][4] | +/- | +/- | +/- | +/- | +/- | +/- | +/- | +/- | +/- | Not applicable | βBUN, βCr, βCK | βK, βMg, βCa, βP | Ingested drug, Glucose, Aminoacid, Phosphate, Ketone, Hyaline cast, RBC | βLactate, Metabolic acidosis | Toxicology, Rapid immunoassay | Nephropathy | Radioopaque substances, Ingested drug packets | Not applicable | Not applicable | – | – | |
| Peritonitis[5][6] | +/- | – | +/- | – | +/- | +/- | +/- | – | – | Leukocytosis | Not applicable | Not applicable | Not applicable | Not applicable | Ascitic fluid neutrophil count > 500 cells/Β΅L | Not applicable | Not applicable | Not applicable | Not applicable | – | – | |
| Toxic megacolon[7] | +/- | +/- | +/- | – | + | + | +/- | – | – | Leukocytosis, Anemia, βESR and CRP | βBUN, βCr | βNa | Not applicable | Not applicable | Loss of haustra, Hypoechoic and thick bowel walls, Dilated colon > 6cm, Dilatation of ileal loops | Dilated colon, Free intraperitoneal air | Bowel perforation, Abscess | Not applicable | Not applicable | Endoscopy and colonoscopy | – | |
| Renal causes | Acute interstitial nephritis[8][9] | +/- | – | +/- | – | +/- | +/- | +/- | +/- | +/- | Eosinophilia | βBUN, βCr, βFENa | Not applicable | Eosinophiluria, Sterile pyuria, Microscopic hematuria, Proteinuria | Not applicable | βTotal IgG, βIgG4 | Normal-sized kidneys | Not applicable | Not applicable | Not applicable | – | History of long term analgesic use |
| Hemolytic uremic syndrome[10][11][12] | +/- | – | +/- | +/- | +/- | + | + | – | +/- | Severe anemia, Thrombocytopenia, β aPTT | βBUN, βCr | Not applicable | Mild proteinuria, Red blood cells, Red blood cell casts | Not applicable | Schistocytes, βFDP and D-dimer, β Bilirubin, βLDH, βHaptoglobin, Stool culture (for E coli 0157:H7 or shigella), βADAMTS-13 activity | Ruling out obstruction | Not applicable | Not applicable | Not applicable | Diffuse thickening of the glomerular capillary wall, Swelling of endothelial cells, Fibrin thrombi in renal biopsy | – | |
References
- β Pletcher MJ, Maselli J, Gonzales R (December 2004). “Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey”. Am. J. Med. 117 (11): 863β7. doi:10.1016/j.amjmed.2004.07.042. PMIDΒ 15589492.
- β Cherpitel CJ (March 1989). “Breath analysis and self-reports as measures of alcohol-related emergency room admissions”. J. Stud. Alcohol. 50 (2): 155β61. PMIDΒ 2927129.
- β Toto RD, Mitchell HC, Lee HC, Milam C, Pettinger WA (October 1991). “Reversible renal insufficiency due to angiotensin converting enzyme inhibitors in hypertensive nephrosclerosis”. Ann. Intern. Med. 115 (7): 513β9. PMIDΒ 1883120.
- β Bismuth C, Gaultier M, Conso F, Efthymiou ML (1973). “Hyperkalemia in acute digitalis poisoning: prognostic significance and therapeutic implications”. Clin. Toxicol. 6 (2): 153β62. doi:10.3109/15563657308990513. PMIDΒ 4715199.
- β Such J, Runyon BA (October 1998). “Spontaneous bacterial peritonitis”. Clin. Infect. Dis. 27 (4): 669β74, quiz 675β6. PMIDΒ 9798013.
- β Runyon BA (October 1990). “Monomicrobial nonneutrocytic bacterascites: a variant of spontaneous bacterial peritonitis”. Hepatology. 12 (4 Pt 1): 710β5. PMIDΒ 2210672.
- β Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN (July 1969). “An experience of ulcerative colitis. I. Toxic dilation in 55 cases”. Gastroenterology. 57 (1): 68β82. PMIDΒ 5305933.
- β Schwarz A, Krause PH, Kunzendorf U, Keller F, Distler A (September 2000). “The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis”. Clin. Nephrol. 54 (3): 179β90. PMIDΒ 11020015.
- β Praga M, GonzΓ‘lez E (June 2010). “Acute interstitial nephritis”. Kidney Int. 77 (11): 956β61. doi:10.1038/ki.2010.89. PMIDΒ 20336051.
- β Noris M, Remuzzi G (April 2005). “Hemolytic uremic syndrome”. J. Am. Soc. Nephrol. 16 (4): 1035β50. doi:10.1681/ASN.2004100861. PMIDΒ 15728781.
- β Goodship TH, Cook HT, Fakhouri F, Fervenza FC, FrΓ©meaux-Bacchi V, Kavanagh D, Nester CM, Noris M, Pickering MC, RodrΓguez de CΓ³rdoba S, Roumenina LT, Sethi S, Smith RJ (March 2017). “Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference”. Kidney Int. 91 (3): 539β551. doi:10.1016/j.kint.2016.10.005. PMIDΒ 27989322.
- β Loirat C, Fakhouri F, Ariceta G, Besbas N, Bitzan M, Bjerre A, Coppo R, Emma F, Johnson S, Karpman D, Landau D, Langman CB, Lapeyraque AL, Licht C, Nester C, Pecoraro C, Riedl M, van de Kar NC, Van de Walle J, Vivarelli M, FrΓ©meaux-Bacchi V (January 2016). “An international consensus approach to the management of atypical hemolytic uremic syndrome in children”. Pediatr. Nephrol. 31 (1): 15β39. doi:10.1007/s00467-015-3076-8. PMIDΒ 25859752.
Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
