Young woman with high fever and a massive rise in N-terminal pro-B-type natriuretic peptide (NT-pro-BNP)

A 33-year-old lady presented with acute symptoms suggestive of pneumonia. She rapidly deteriorated and needed intensive care unit care. She was found to have an enormous rise in N-terminal pro-B-type natriuretic peptide (NT-Pro-BNP), nearly in six digits without any previous co-morbidity. NT-Pro-BNP high levels could be reflective of cardiac injury, heart failure (HF), or chronic kidney disease (CKD), and a few other medical conditions. The final diagnosis was for acute on chronic kidney disease.