GREGORY L. EASTWOOD, M.D.
To the editor: The implication in the answer given to the first Question of the Month for October 1969 (1) requires some clarification. The patient had lumbar pain, anemia, high-normal blood urea nitrogen, and 3 + proteinuria. Further evaluation of the patient was to include all of the procedures listed except one—intravenous pyelography. In the reference for that answer (2) Dr. Linman points out that several instances of acute renal failure have followed intravenous pyelography in patients with plasmacytic myeloma and cites dehydration and abdominal pressure as factors that may enhance precipitation of Bence Jones protein in the renal tubules.
EASTWOOD GL. Dissent on Question of the Month. Ann Intern Med. ;72:284–285. doi: 10.7326/0003-4819-72-2-284_2
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Published: Ann Intern Med. 1970;72(2):284-285.
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