A 66-Year-Old Woman Found Unresponsive

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Case Presentation

Background:

• Morning reports are traditional medical education forums for case discussion.
• This report follows the Morning Report format to present a complex clinical case.
• The patient has a history of renal transplantation and chronic kidney disease.

Purpose of the Study:

• To present an interesting case of an unresponsive patient with a complex medical history.
• To guide readers in developing a differential diagnosis for the presented symptoms.
• To illustrate the process of refining a diagnosis through clinical evaluation.

Main Methods:

• Case presentation of a 66-year-old female.
• Utilized patient history, physical examination, and diagnostic testing.
• Employed an "illness script" approach to differential diagnosis.

Main Results:

• The patient presented with coma, respiratory distress, and abnormal limb movements.
• Diagnostic process involved iterative refinement of the differential diagnosis.
• A final diagnosis was reached through progressive clinical assessment.

Conclusions:

• Complex cases require a systematic approach to diagnosis.
• Morning reports facilitate collaborative learning and diagnostic reasoning.
• This case highlights the diagnostic challenges in patients with prior renal transplantation.