The clues so far:
Renal ultrasound shows no sign of kidney obstruction.
Blood tests show that the missing blood cells did not leave her body through any orifice, nor were they destroyed inside her. Instead, she's anemic because her marrow has stopped making new blood cells to replace the ones that die naturally at the end of their four-month lifespan.
My theory of the crime:
Pure red cell aplasia complicated by acute tubular necrosis. Meaning, maybe she has an odd autoimmune bone marrow problem that caused her to stop making red blood cells a few months ago. With no new blood cells to replace the old ones that die off each day, she developed progressive anemia. This stressed out her kidneys, which didn't get enough oxygen and eventually shut down in shock.
Okay, so I've never actually seen kidneys shut down from severe anemia, but theoretically it's possible. And it's the best theory my tiny brain is coming up with.
Plan:
Transfusion (done immediately)
Bone marrow biopsy (done yesterday).
Steroid therapy if pure red cell aplasia is proven.
Dialsysis every other day for now.
Cross my fingers and hope her kidneys wake up.
Renal biopsy if they don't.
Bone marrow biopsy results take days to come back from the Land o' Pathology. I'm on the edge of my seat.
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