{"text":"NHS Confidenlial: Perscnal dala abont a palisat \nwww.nhsknmrkshir\u00e9,oig.uk * . Monklands Hospital \nDepartment of Gastroenterology Monkscourt Avenue \nDirect Line to Secretary 01698 752 317 Airdrie ) : \n' ML6 0TS ) VA \n\u2018 _ Lanarkshire \n\"Renal Medicine Consultant ) Date Dictated: 17\/02\/2022 \nRenat Medicine . Date Typed: 17\/02\/2022 \nMonklands Hospital ) . Ref, . 2729950 . \nMonkscourt Avenue Letter Ref: \nJV\/IVR \nAirdire CH! Barcode: > \nM6 0JS : \n* 1209823403 % \nNew Condition \nUrgent Internal \u2019 . \n\" Dear Colleagues \nPatient Name: Patricia Hunt \nPatient date of birth: 12\/09\/1982 \nPatient Address: 22 Cutlmuir View, Croy, Glasgow, G65 9HH \nI would be grateful il you would consider seeing this 39-year-old lady in clinic. She was seen in Adam Wimpress' \nGastroenterology clinic in December 2021 having been referred with recurrent iron deficiency anemia, upper abdominal \npain and unintentional weight loss. : \nBloods checked in \u00a2linic in Deceniber 2021 showed abnormal renal function (urea 15.6, creatinine 121, bicarbonate 16, \nK+ 3 and eGFR 49). Her anaemia was noted to be improving with haematinic replacement, and a previously identified \nthrombocytosis had resolved. She was not taking any nephrotoxic medicines at that stage. The last time her kidney blood \nlests were checked prior to this was November 2019 in which stage they were normal (urea 6,6, creatinine 71 and \u00a2GFR \n;;\u2018S()) . \n) . ! . . . . \nA contrast enhanced (T sean of her chest, abdominal and pelvis Tast month showed no cause for the unintentional weight \nloss or iron deficiency anemia. The was an incidentaf finding of emphysema. \nA colonoscopy and dietetic review were planned, but she didl not attend the appointments. \nHer kidney blood tests were repeated on the 24% January 2022 (GGC portal) showing some improvement (urea 5.2, \ncreatinine 105 and \u00a2GFR 51}, and a further improvement when checked again on the 9\" February 2022 (NHSL Portat) - \nurea 3.4, creatinine 96, \u00a2GFR >59 (sodium and bicarbonate noral; K+ 5.1 without replacement). Her imnuinoglobuting \nare normal and seram protein electrophoresis (GGC Portal) showed no evidence of a paraprotein. \n[ undersiand she has microscopic haematuria and her urine microslbumin\/ereatinine ratio is clevated (15.4 mg\/mmol of \ncreatinine). ANCA and Anti-GBM antibodies are negative and ANA is positive (1\/160 Speckled). Her ESR is normal. \nA renal ultrasound scan showed her right Kidney to be smaller than her left (9.5cm and 11.5\u00a2m respectively). There were \ncysts in both kidneys and increased echogenicity in the calyces which the reporting Sonographer has suggested ey \nsuggest nephrocaleinosis. 1t was noted also in the report that there has been s significant change in the renal appearances \nsince her previous ultrasound scan in 2013. There was no evidence of renal obstruction or a renal mass lesion. Her \n.adjusted cafcium is normat, \nGiven she has not attended for dietetic review or the planned colonoscopy it has been arranged for her to come back to Dr \nWimpress' gastroenterology clinic in early March for further review and to explore the reasons for her non-attendance. \nWe plan to check her HIV, HBV and HCV serology at this appointment also. \nIn fight of the renal findings, I'd appreciated your thoughts, If you need any further information, please just let me know. \nWith best wishes, ) ' \nYours 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