Croscopic hematuria and significant eosinophiluria (2 ) without proteinuria. The patient’s serum UA was 2.9 mg/dl, creatine kinase was 1,155 U/l, and Prothrombin Time (PT) was 52 with an International Normalized Ratio (INR) of 1.6. All other laboratory tests were within the normal range (Table 1). Renal PNPPMedChemExpress PNPP ultrasound showed only mild cortical hyperechogenicity, and renal vasculature was normal. The patient was not taking medications, and his medical history was unremarkable except for recurrent episodes of loin pain (frequently radiating to the right groin with fever and vomiting) over the last five years. These episodes had started frequently after cricket matches or other physical activities. The family history was unremarkable except for a 28-year-old sister, who was noted to have similar episodes of recurrent loin pain and vomiting. Intravenous infusions of 5 dextrose, normal saline and 1/6 M sodium bicarbonate were started. The next day, kidney function worsened further, and one hemodialysis session was performed. A presumptive diagnosis of acute renal failure due to tubulo-interstitial nephritis was made, and prednisone therapy was started (67.5 mg/day, i.e., 1 mg/kg BW/day). Kidney function gradually improved after the first dialysis session, and over the following nine days, there was complete recovery of renal function along with the disappearance of loin and groin pain and fever. Laboratory tests repeated before discharge were unremarkable, except for a very low plasma PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26080418 UA level (0.2 mg/dl). Steroid treatment was rapidly tapered off, and the patient was discharged on the thirteenth day with a serum creatinine level of 1.6 mg/dl.Jeannin et al. BMC Medical Genetics 2014, 15:3 http://www.biomedcentral.com/1471-2350/15/Page 3 ofTable 1 Patient’s laboratory tests at admission and discharge for both hospitalization episodesSerum parameters Hemoglobin Platelets White blood cells Eosinophils Aspartate transaminase Alanine transaminase Lactate dehydrogenase Creatine kinase Serum proteins C reactive protein INR* Partial thromboplastin time Serum creatinine Serum UA Urine UA FE-UA -men -women Serum sodium Serum potassium Serum calcium Serum phosphate Venous HCO?3 mmol/l mmol/l mg/dl mg/dl mmol/l seconds mg/dl mg/dl mg/day 6-12 6-20 135-145 3.5-5 8.6-10.6 2.7-4.5 24-28 140 3.3 9.2 6.2 19 141 3.5 8.8 3.6 26 142 3.5 10.1 2.2 26 142 3.6 9.3 3.6 30 Units g/dl x103/mmc x103/mmc U/l U/l U/l U/l g/dl mg/l Reference values 14-18 130-400 4-10.8 0-8 5-50 5-50 125-220 20-170 6-8 <5 0.9-1.2 24-38 0.5-1.2 2.35?.90 250-750 1st admission 13.4 204 8.220 3 29 13 191 1155 6.6 15.4 1.6 38 12.0 2.9 1.4 40 1.6 0.2 575 >150 (200 ) 1st discharge 13.8 236 12.250 0 16 11 208 203 2nd admission 14.7 244 9.900 2 37 16 233 723 7 17.5 1.3 34 2.1 0.38 1.3 35 0.9 0.09 411 >150 (732 ) 7 12 115 25 2nd discharge 14.2 254 7.*INR: International Normalized Ratio.Five months later, the patient presented again with recurrent loin pain, vomiting, diarrhea and acute renal failure (creatinine 2 mg/dl); two days before he had played a cricket match and the day before he had taken 1 g of paracetamol to treat a fever above 38 . The physical examination only showed bilateral loin tenderness; there were no signs of fluid overload, blood pressure was 121/68 mm Hg without orthostatic hypotension, and body temperature was 37 . The chest radiogram was normal, and renal ultrasonography showed normal-sized kidneys with only slightly increased echogenicity. Blood tests (Table 1) showed se.