Case Report
Granulomatous Interstitial Nephritis Presenting as Hypercalcemia and Nephrolithiasis
Table 1
Lab values during hospitalization and after discharge.
| | Variable | Baseline labs, 6 months before admission | Hospital day 1 | Hospital day 2 | Hospital day 6 |
Hospital day 12,1 time dexamethasone was given |
Hospital Day 16 (prednisone 60 mg Qd started) | Day 18 (discharge day) | 15 days after discharge | Reference range |
| | Sodium | 139 | 135 | 134 | 136 | 138 | 138 | 135 | 139 | 136–146 mmol/L | | Potassium | 4.4 | 5.3 | 5.3 | 4.9 | 5.2 | 5.1 | 4.3 | 4.9 | 3.5–5.1 mmol/L | | Chloride | 104 | 101 | 106 | 112 | 104 | 110 | 111 | 104 | 96–107 mmol/L | | Carbon dioxide | 25 | 21 | 17 | 18 | 16 | 17 | 17 | 19 | 22–30 mmol/L | | Blood urea nitrogen | 23 | 57 | 57 | 40 | 57 | 65 | 67 | 68 | 8–24 mmol/dl | | Creatinine | 1.79 | 7.59 | 7.6 | 6.49 | 6.79 | 4.98 | 4.52 | 2.89 | 0.66–1.25 mg/dL | | Glucose | 137 | 167 | 148 | 99 | 106 | 216 | 145 | 94 | 74–106 mg/dL | | eGFR | 40 | 8 | 7 | 9 | 9 | 12 | 14 | 23 | >90 | | Calcium | 10.5 | 13.5 | 12.9 | 10.9 | 13.1 | 9.3 | 8.1 | 9.6 | 8.4–10.3 mg/dL | | Corrected calcium | 10.4 | Unable to calculate | 13.4 | 11.8 | 13.2 | 10.3 | Unable to calculate | 9.8 | 8.5–10.5 mg/dL | | Ionized Ca | Not checked | Not checked | 1.7 | Not checked | Not checked | Not checked | 1.12 | Not checked | 1.16–1.32 mmol/L | | Phosphorus, inorganic | Not checked | 7.4 | 6.1 | 4.7 | 7.5 | Not checked | Not checked | 3.4 | 2.5–4.5 mg/dL | | Protein, total | 7.3 | Not checked | 6 | 5.5 | 7.2 | 5.3 | Not checked | 6.2 | 6.3–8.2 g/dL | | Albumin | 4.1 | Not checked | 3.4 | 2.9 | 3.9 | 2.8 | Not checked | 3.7 | 3.5–5 g/dL | | Bilirubin, total | 0.6 | Not checked | 0.6 | 0.3 | 0.5 | 0.3 | Not checked | 0.4 | 0.2–1.3 mg/dL | | Bilirubin, direct | 0.1 | Not checked | Not checked | Not checked | Not checked | 0.2 | Not checked | 0.3 | 0.0–0.4 mg/dL | | ALP | 68 | Not checked | 43 | 42 | 113 | 66 | Not checked | 67 | 38–126 U/L | | AST | 26 | Not checked | 22 | 21 | 23 | 28 | Not checked | 20 | 15–46 U/L | | ALT | 24 | Not checked | 23 | 28 | 39 | 52 | Not checked | 25 | 13–69 U/L | | WBC | 12.8 | 12.8 | 13.2 | 8.6 | 10.8 | 18.7 | 13.1 | 14.8 | 3.4–11 k/L | | Hemoglobin | 13 | 13 | 11.2 | 10.6 | 12.1 | 10.3 | 9.9 | 12.4 | 13.0–17 g/dL | | Hct | 39.2 | 39.2 | 33.6 | 33.1 | 37.2 | 32.1 | 31.8 | 37 | 38–51% | | Platelet | 386 | 386 | 302 | 298 | 295 | 306 | 105 | 300 | 150–450 k/L | | MCV | 83.2 | 83.3 | 84.1 | 85.9 | 85.3 | 85.9 | 85.5 | 87.6 | 80–100 fL | | Eosinophils (%) | 5.2 | 5.2 | 3.9 | 6.7 | 7.1 | 0.4 | Not checked | 2.1 | 0.0–0.6% | | Neutrophil (%) | 77.6 | 77.6 | 77.8 | 70 | 69 | 91.1 | Not checked | 91 | 40–74% | | Lymphocytes (%) | 9 | 9 | 10 | 12.7 | 13.6 | 4.8 | Not checked | 4.3 | 18–44 | | Monocytes (%) | 7.7 | 7.7 | 7.9 | 10.1 | 10.1 | 3.7 | Not checked | 2.4 | 4.7–12.0% | | Basophil (%) | 0.3 | 0.5 | 0.4 | 0.5 | 0.2 | 0 | Not checked | 0.2 | 0.1–1.4% |
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The normal albumin level is defaulted to 4.
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