With a working diagnosis of syphilis-related rapidly glomerulonephritis,
patient was admitted and started on intramuscular benzathine penicillin
G 2.4 million IU weekly for 3 doses, intravenous furosemide 40 mg twice
daily, amlodipine 10 mg once daily by mouth, intravenous metoclopromide
10 mg thrice daily, intravenous omeprazole 20 mg once daily, and no salt
added diet. She was also challenged with 500 milliliters of normal
saline for possible superimposed pre-renal component due to vomiting.
She did not receive steroid or any other form of immunosuppressive
therapy. Two days after first dose of benzathine penicillin G, the serum
creatinine declined rapidly from 9.28 to 7mg/dl. After the third dose it
became 0.98 mg/dl and had been stable since (Table 2). Currently she
feels well, non-edematous, normotensive and normal and stable renal
function.
Table 2. Timeline of the patient’s serial laboratory investigation