Miracles in nephrology still happen
Poster Session – Honorable Mention
This morning I highlighted a number of interesting posters. While all the posters deserve mention, I’ll take space here to discuss one particular. The title, “Puzzling case of renal failure regression after tumor resection in a hepatitis C-associated cryoglobulinemic MPGN”, by Drs. V. Gupta, A. Ladani, M. Nalle, and M. Lawlor, immediately caught my attention. I instantly imagined how unlucky this patient was to have been afflicted by four medical conditions….that is, until I went beyond the title and read the poster.
Medicine is filled with miraculous stories and this poster highlights such a miracle. The patient, a 57-year old male with stable hepatitis C, was diagnosed with acute renal failure during, what appeared to be, a routine hospitalization for abdominal distention and scrotal edema. Unfortunately, the patient’s acute renal failure did not resolve and a subsequent kidney biopsy sealed his fate with membrano-proliferative glomerulonephritis. Serologic testing revealed the presence of cryoglobulins. Therapy was unsuccessful and the patient was started on hemodialysis.
Thirteen months later, still receiving hemodialysis, things went from bad to worse as the patient was diagnosed with rectal cancer. Not only was he a “new” dialysis patient, he was now a cancer patient and began neoadjuvant chemoradiation and, ultimately, underwent surgical resection.
Here’s where his story becomes “miraculous”. After the surgical resection and chemoradiation, the patient was not only cancer free, but dialysis free as well. Despite 13 months of hemodialysis and the biological changes that are associated with renal replacement therapy, the patient gained independence from hemodialysis within a month of tumor resection. At last follow-up in 2012, he remains dialysis and cancer free.
We’ve all got stories of miraculous recoveries, and each is special in its own way. This case reminded me of the continued miracles that happen in nephrology daily. We need more posters like these to remind all of us that miracles still happen.
Please check out the interview with Dr. Vineet Gupta, presenter of this poster.
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