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Clinical Crossroads
Clinician's Corner
March 2, 2005

A 44-Year-Old Woman With Kidney Stones

Author Affiliations

Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.


Author Affiliation: Dr Curhan is Associate Professor of Medicine and Epidemiology, Harvard Medical School and Harvard School of Public Health, Boston, Mass. He divides his time between the Channing Laboratory and the Renal Division at Brigham and Women’s Hospital, Boston, Mass.

JAMA. 2005;293(9):1107-1114. doi:10.1001/jama.293.9.1107

DR BURNS: Ms P is a 44-year-old woman with a history of morbid obesity and superficial thrombophlebitis who was diagnosed with kidney stones 1 month ago. She recently lost her medical insurance and is applying for free care. She is currently unemployed and lives with her daughter.

While on vacation in Jamaica, Ms P developed severe diarrhea without nausea, vomiting, or fever. After returning to the United States her diarrhea resolved, but she developed brown urine that lasted for several days. She subsequently developed bilateral intermittent low back pain that she treated with acetaminophen and ibuprofen with good relief. She denied any radiation of the pain or any associated weakness or numbness. She had no fever, dysuria, or urinary frequency. She never had similar symptoms in the past. She does not smoke and denies alcohol use.

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