A 40-year-old female tennis player with tendonitis is taking large doses of an over-the-counter nonsteroidal anti-inflammatory agent.After taking the medication for several weeks,she develops a skin rash and observes a decrease in urine volume.Results of her urinalysis are:

-What is the probable diagnosis?

Question

A 40-year-old female tennis player with tendonitis is taking large doses of an over-the-counter nonsteroidal anti-inflammatory agent.After taking the medication for several weeks,she develops a skin rash and observes a decrease in urine volume.Results of her urinalysis are:
 
-What is the probable diagnosis?

Quizplus · Accepted Answer

The combination of skin rash and decreased urine volume suggests a hypersensitivity reaction, which may lead to acute interstitial nephritis as a possible diagnosis. Nonsteroidal anti-inflammatory agents are one of the most common causes of acute interstitial nephritis. The urinalysis findings are consistent with an interstitial nephritis pattern. Fanconi syndrome is characterized by abnormal urinary excretion of amino acids, glucose, phosphate, and bicarbonate, among other things. Acute tubular necrosis is characterized by the presence of granular casts and renal tubular cells in the urine, which are not observed in this case. Acute glomerulonephritis is characterized by hematuria, proteinuria, and red blood cell casts, which are not observed in this case.

A 40-Year-Old Female Tennis Player with Tendonitis Is Taking Large