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Case Records of the Massachusetts General HospitalFree Preview

Case 5-2021: A 68-Year-Old Man with Delirium and Renal Insufficiency

List of authors.
  • David B. Hellmann, M.D.,
  • Jo-Anne O. Shepard, M.D.,
  • Pamela W. Schaefer, M.D.,
  • Jacob H. Johnson, M.D.,
  • and Rory K. Crotty, M.B., B.Ch.

A 68-year-old man with a history of bladder cancer presented with delirium, renal insufficiency, unintentional weight loss, and leukopenia. Examination was notable for a subtle facial droop on the left side, bibasilar crackles in the lungs, and hepatosplenomegaly. A diagnosis was made.

Funding and Disclosures

This case was presented at the Harvard Medical School 2019 postgraduate course Advances in Rheumatology, organized by Dr. John H. Stone.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

No potential conflict of interest relevant to this article was reported.

Author Affiliations

From the Department of Medicine, Johns Hopkins Medicine, Baltimore (D.B.H.); and the Departments of Radiology (J.-A.O.S., P.W.S.) and Pathology (R.K.C.), Massachusetts General Hospital, the Departments of Radiology (J.-A.O.S., P.W.S.), Medicine (J.H.J.), and Pathology (R.K.C.), Harvard Medical School, and the Department of Medicine, Brigham and Womens Hospital (J.H.J.) all in Boston.

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