# Acute Onset of Mesoamerican Nephropathy in a Patient With Chronic Gout and Occupational Exposure: A Case Report

## TL;DR

A 40-year-old man from El Salvador with gout and agricultural work history developed Mesoamerican nephropathy, a chronic kidney disease linked to environmental and medical risk factors.

## Contribution

This case report highlights the acute onset of Mesoamerican nephropathy in a patient with known risk factors, adding to its clinical understanding.

## Key findings

- The patient showed elevated creatinine and BUN with reduced GFR, indicating kidney dysfunction.
- The patient's history of agricultural work and long-term use of nephrotoxic drugs aligned with MeN risk factors.
- The case demonstrates that MeN can present acutely in individuals with pre-existing chronic conditions.

## Abstract

Mesoamerican nephropathy (MeN) is a form of chronic kidney disease that is becoming increasingly prevalent. Multiple risk factors, including male gender, exposure to pesticides, heat stress, use of nephrotoxic medications, and a geographical association with Central America, have been linked to this condition. We present the case of a 40-year-old male from El Salvador who sought medical attention due to abnormal laboratory results and a flare-up of gout. The patient exhibited elevated creatinine and blood urea nitrogen (BUN) levels, with a significantly reduced glomerular filtration rate (GFR). His renal function had been stable three months earlier, when he had established care with his primary care physician. The patient had a history of agricultural work in El Salvador, along with long-term use of colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs) for gout flare-ups. Following consultation with nephrology, he was diagnosed with MeN due to his relevant risk factors and clinical presentation. This case highlights the acute onset of MeN in a patient with established risk factors.