by C. Hugo Department of Clinical Medicine IV, Division of Nephrology and Hypertensiology, Friedrich-Alexander University Erlangen-Nuremberg Erlangen, Germany
Introduction: AB, an 84 year-old woman, body mass index 22 kg/mq, was submitted in September 1999 to hemicholectomy because of carcinoma of sigma; at that period renal function was normal (serum Creatinine -SCr- 0.6 mg/dl, GFR according to the MDRD formula 82 ml/min). A 45-year-old Caucasian man was admitted to a peripheral hospital due to increasing pain in his right leg which had started five days before. The symptoms of the leg included pretibial edema, pallor, paresthesia, and paralysis. No peripheral pulses could be detected in his right foot. Five days previously the patient had felt perfectly well. He was not taking any medicine, nor did he report any hospital admissions or surgery prior to the current event. He was diagnosed as having borderline hypertension with values of about 150/90 mmHg, but no treatment was proposed as yet. He was a heavy smoker, consuming 90 cigarettes daily and 200 packs per year. Body weight was 70kg, body mass index was 26.4 kg/m2, blood pressure 150/80, heart rate 80/min, temperature 37.0 C, breathing normal. Leukocytosis of 15.700/mm3, Hb 17.0 g/dl, platelets 364000/mm3, CRP slightly increased to 2.3 mg/dl. Serum creatinine was 1.1 mg/dl, Hst-N and diuresis normal. Cardiac, abdominal, neurological and pulmonary status was normal.
Question 1) - What is the diagnosis in this patient? (Only ONE answer is correct)