An unusual cause of hematuria.

Hematuria is a cardinal manifestation of renal disease and forms a cornerstone of nephrologic diagnosis. A systemic approach is required to delineate the source of hematuria to the kidney or urinary tract. We present the case of 14 years old boy who presented to us with history of passing red colour urine since 3 month not associated with pain who was subsequently diagnosed to have of Thin Basement Membrane Disease.

Adult onset distal renal tubular acidosis: a disorder of an autoimmune disease.

We present the case of 36 yrs old female who presented with acute onset quadriparesis who was subsequently diagnosed to have Sjogrens syndrome with distal RTA with hypothyroidism.

Recurrent pyogenic meningitis in a 17-year-old: a delayed presentation of X-linked agammaglobulinemia with growth hormone deficiency.

We report an adolescent male with X-linked agammaglobulinemia (XLA) and recurrent episodes of pyogenic meningitis. The workup for proportionate short stature revealed isolated growth hormone deficiency. This patient highlights the delayed presentation of the XLA variant and the need to consider primary immunodeficiency in patients with recurrent serious infections, irrespective of age.

Trauma precipitating thyroid storm.

A 40 year old male victim of a road traffic accident presented to our emergency trauma services with multiple limb injuries and a Glasgow Coma Score (GCS) of 15/15. Soon after admission, he became confused, stuporous, febrile and tachycardic. A clinical diagnosis of thyrotoxic crisis precipitated by trauma was confirmed by relevant investigations, with appropriate therapeutic response. A review of the clinical features and management of this rare medical emergency, with only few cases reported worldwide, is presented.

Rare variety of T-cell lymphoma.

We report a case of 18 year old male who presented with hepatosplenomegaly, anemia and thrombocytopenia. His complete hemogram, peripheral smear, bone marrow studies were inconclusive. On immunophenotyping he was diagnosed as "Hepatosplenic gamma delta (gammadelta) T cell lymphoma" which is a very rare variety of T cell lymphoma. Less than 100 cases have been described in the literature since the entity was first described in 1990.

VACTERL Association.

Here we report a case of VACTERL ASSOCIATION in a twenty three years old married female patient primigravida with 3 months of amenorrhea admitted with history of fever and gastroenteritis along with congenital developmental defects such as scoliosis (V), small ventricular septal defect (C), right sided hemifacial dysmorphic features (right mandibular hypoplasia), small sized right sided kidney (R), bilateral hypoplastic thumb (L). For the diagnosis of VACTERL atleast three out of seven anomalies should be present while our patient had four anomalies.

A case of nephrotic syndrome with Gitelman's syndrome.

Nephrotic syndrome, though common in children, association of it with Gitelman's syndrome (GS) is a rare occurrence. Very few cases have been reported in the medical literature so far. Here we report a case of nephrotic syndrome with frequent relapses and remissions on intermittent steroid and diuretic therapy. Patient was restarted on steroids and frusemide. Puffiness of face, bipedal edema and oliguria improved but patient developed tingling numbness in both limbs, perioral numbness and carpopedal spasm. On investigation she was found to have proteinuria, metabolic alkalosis, hypokalemia, hypocalcemia, hypomagnesemia and hyperreninemia with normal blood pressure.