A Rare Case of Page Kidney With Superimposed Infection

Emerald Zaw; Jared J Bies; Hein Zay; Eyoab Massebo; Mariam Hassan; Swathi Prakash; Thwe Htay; Mariela Lane

doi:10.7759/cureus.50842

A Rare Case of Page Kidney With Superimposed Infection

Cureus. 2023 Dec 20;15(12):e50842. doi: 10.7759/cureus.50842. eCollection 2023 Dec.

Authors

Emerald Zaw¹, Jared J Bies², Hein Zay², Eyoab Massebo², Mariam Hassan², Swathi Prakash², Thwe Htay³, Mariela Lane¹

Affiliations

¹ Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
² Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
³ Medical Education, Texas Tech University Health Sciences Center El Paso, El Paso, USA.

Abstract

Page kidney (PK) is a rare renal condition characterized by external compression of the kidney, typically by a subcapsular hematoma, leading to resistant secondary hypertension due to hypoperfusion and ischemia. This hypertension is caused by the external compression of the kidney by a chronic subcapsular hematoma that activates the renin-angiotensin-aldosterone system (RAAS) system. Hematoma formation can result from external or internal trauma. The resolution of the hematoma can take months, and, in some cases, may necessitate a nephrectomy. Unresolved subcapsular hematomas can be complicated by infection, leading to sepsis, hospitalization, and the need for surgical drainage. This report presents a unique case of a 67-year-old female with a spontaneous left renal subcapsular hematoma that did not resolve with conservative measures and was complicated by superimposed infection requiring percutaneous drainage.

Keywords: ace inhibitors and angiotensin receptor blockers; diabetes type 2; interventional radiology guided drainage; klebsiella kidney abscess; klebsiella pneumonea; page kidney; percutaneous abscess drainage; renal subcapsular hematoma; renin-angiotensin-aldosterone system; resistent hypertension.

Publication types

Case Reports