Case 43162

Presentation of CaseA fifty-eight-year-old woman entered the hospital because of loss of weight.She was said to have had "nephritis" with albuminuria during two pregnancies twenty-one and thirty-two years previously. Both pregnancies terminated with stillbirths. Fifteen years before admission a subtotal gastrectomy and a posterior gastroenterostomy were performed because of a long standing duodenal ulcer that failed to heal with medical therapy. Physical examination at that time revealed a blood pressure of 148 systolic, 100 diastolic. The urine gave a ++ test for albumin; the sediment contained an occasional red cell and 10 to 30 white cells per high-power . . .