A 56-year-old man with acute myeloid leukemia develops severe bilateral flank pain and oliguria 3 days after induction chemotherapy. Vital signs: BP 158/92 mmHg, HR 102/min, RR 20/min, Temp 37.2°C, SpO2 98%. Serum uric acid 12.8 mg/dL (markedly elevated); creatinine 3.2 mg/dL. Urinalysis reveals needle-shaped and rhomboid crystals; no hematuria. Abdominal radiograph does not reveal nephrolithiasis. Which diagnosis is most likely?
- A)Uric acid nephrolithiasisGABARITO
- B)Acute interstitial nephritis
- C)Cystine nephrolithiasis
- D)Calcium oxalate nephrolithiasis
- E)Struvite nephrolithiasis
Explicação
Uric acid nephrolithiasis is correct. Tumor lysis increases uric acid production, and uric acid stones are radiolucent and form in acidic urine. The clinical setting of leukemia treatment and marked hyperuricemia is highly characteristic. Ver explicação completa e trilha adaptativa →