A 3 6-year-old African-American female with the sickle cell trait underwent a cadaveric kidney transplant in 2004 secondary to focal sclerosing glomerulonephritis. The patient's posttransplant course was relatively unremarkable for approximately 5 years until she developed BK virus nephropathy manifested by a progressive rise in serum creatinine. She was treated with leflunomide and placed on chronic dialysis. Approximately 2 years later (7 years status post transplant), the patient developed sudden-onset nausea, vomiting, diarrhea, and diffuse abdominal pain. She denied dysuria, fever, chills, hematuria, or weight loss. On physical examination, she was noted to have diffuse abdominal tenderness that was more pronounced in the left lower quadrant, in the region of her transplant kidney. The remainder of the physical examination was unremarkable. Her initial laboratory values were significant for hyperkalemia, anemia, and an elevated creatinine of 5.3.
展开▼
