Case History
A 52-year-old Japanese man presented to the emergency department of our
hospital with a 1-week history of low back pain. He had also developed
difficulty in walking over the previous 2 days. He had a 10-year history
of chronic renal failure caused by glomerulonephritis and was on
hemodialysis three times a week. He had smoked 20 cigarettes/day for 30
years and was an occasional drinker. On examination, he was alert, with
a temperature of 37.0℃, blood pressure of 105/74 mmHg, respiratory rate
of 32 breaths/min, and heart rate of 180 beats/min. No abnormalities
were detected on respiratory or cardiac examination. Abdominal
examination showed tenderness over an area from the right buttock to the
right thigh. There was no redness or tenderness at the dialysis shunt
site, located on the left forearm. Laboratory test results on admission
showed a white blood cell count of 16,200 cells/µL, hemoglobin level of
11.8 g/dL, and platelet count of 102,000 /µL. His serum potassium (8.0
mmol/L) and C-reactive protein (41.7 mg/dL) levels were elevated. His
other blood test results are shown in Table 1.