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Progressive Multiple Sclerosis Presenting With Obstructive Uropathy and Acute Kidney Injury: A Case Report
Ahmed Jamil1, Anup Banerjee1, Amin Suham1
1Acute Medicine, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, GBR.
Cureus
|August 11, 2025
Summary
Very-late-onset multiple sclerosis (VLOMS) can present atypically in older adults. This case highlights how urinary symptoms and acute kidney injury can be the first signs of progressive MS, emphasizing the need for thorough neurological evaluation.
Area of Science:
- Neurology
- Nephrology
- Urology
Background:
- Very-late-onset multiple sclerosis (VLOMS), defined as onset after age 60, is rare and diagnostically challenging.
- Atypical presentations in the elderly can obscure underlying demyelinating disease.
Observation:
- A 67-year-old man presented with urinary symptoms, obstructive uropathy, and acute kidney injury (AKI).
- He had undiagnosed progressive weakness and gait difficulties, later developing facial droop.
- Investigations revealed severe hyperkalemia, uremia, and renal impairment.
Findings:
- Neuroimaging confirmed multifocal demyelinating lesions characteristic of multiple sclerosis (MS).
- Cerebrospinal fluid analysis showed oligoclonal bands, supporting an MS diagnosis.
- The patient's urinary retention and AKI were attributed to neurogenic bladder dysfunction secondary to progressive MS.
Implications:
- This case underscores the importance of considering neurological causes, like MS, in elderly patients with unexplained urinary dysfunction and renal failure.
- Early multidisciplinary assessment is crucial for timely diagnosis and to prevent irreversible kidney damage.
- Recognizing MS in older adults, even with concurrent urological conditions, can significantly improve patient outcomes.
Keywords:
demyelinating disordermultiple sclerosisobstructive uropathyprogressive multiple sclerosisvery late onset multiple sclerosisMore Related Videos
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