PMC10102923_01
Electrolyte trend on admission reflecting Gitelman pattern.
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Laboratory findings include potassium of 3.1 mEq/L (3.5-5), ionized calcium of 1.06 mmol/L (1.12-1.38), magnesium of 1.5 mg/dL (1.8-2.4) remained low despite replacement (Figure 1), phosphorus of 3.2 mg/dL (2.5-4.5), alkaline phosphatase of 190 U/L (45-117), aspartate aminotransferase of 75 U/L (15-37), alanine aminotransferase of 117 U/L (12-78), gamma-glutamyl transferase of 662 U/L (5-85), total bilirubin of 1.5 mg/dL (0.2-1), albumin of 2.8 gm/dL (3.1-4.5), glycosylated hemoglobin (A1C) of 15.4% (4-6), C peptide of 1.1 (1.1-4.4), and anti-nuclear antibody of >1:80 with a speckled pattern.
CECT of the abdomen showing a head of the pancreas with no body and tail (blue arrow),
and multicystic left kidney (red arrow).
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CECT of abdomen and pelvis showed multiple renal cystic lesions and incidental finding of absent body and tail of the pancreas with no evidence of surgical pancreatectomy (Figure 2).
MRI confirming missing body and tail of the pancreas (blue arrow).
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Further imaging was pursued with magnetic resonance imaging (MRI), which confirmed the absent tail and body of the pancreas, numerous simple and proteinaceous cystic lesions on the left kidney, unremarkable liver, and bile duct (Figure 3).