Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice

ABSTRACT Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. After evaluation by the cardiology and hematology services, the diagnosis of AL amyloidosis with cardiac involvement was confirmed. This case emphasizes the importance of extending the physical examination using POCUS, which, ideally, should not be restricted to the urinary tract.

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Main Authors: Silva,Ana Cláudia da, Bonato,Fabiana Oliveira Bastos, Bastos,Marcus Gomes
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Nefrologia 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300445
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spelling oai:scielo:S0101-280020210003004452021-11-05Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practiceSilva,Ana Cláudia daBonato,Fabiana Oliveira BastosBastos,Marcus Gomes Amyloidosis Ultrasonography Nephrotic Syndrome ABSTRACT Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. After evaluation by the cardiology and hematology services, the diagnosis of AL amyloidosis with cardiac involvement was confirmed. This case emphasizes the importance of extending the physical examination using POCUS, which, ideally, should not be restricted to the urinary tract.info:eu-repo/semantics/openAccessSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology v.43 n.3 20212021-09-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300445en10.1590/2175-8239-jbn-2020-0069
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libraryname SciELO
language English
format Digital
author Silva,Ana Cláudia da
Bonato,Fabiana Oliveira Bastos
Bastos,Marcus Gomes
spellingShingle Silva,Ana Cláudia da
Bonato,Fabiana Oliveira Bastos
Bastos,Marcus Gomes
Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
author_facet Silva,Ana Cláudia da
Bonato,Fabiana Oliveira Bastos
Bastos,Marcus Gomes
author_sort Silva,Ana Cláudia da
title Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
title_short Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
title_full Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
title_fullStr Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
title_full_unstemmed Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
title_sort conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice
description ABSTRACT Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. After evaluation by the cardiology and hematology services, the diagnosis of AL amyloidosis with cardiac involvement was confirmed. This case emphasizes the importance of extending the physical examination using POCUS, which, ideally, should not be restricted to the urinary tract.
publisher Sociedade Brasileira de Nefrologia
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300445
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