2019-05-01_Discover

18 DISCOVERMAGAZINE.COM

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BY AMITHA KALAICHANDRAN

hospital, where I and other doctors

examined her.

Ameera spoke in a quiet voice. She

answered most questions by nodding yes

or no, as her parents sat nearby. They said

that over the last few weeks, Ameera felt

nauseous, had to urinate often and was

often thirsty. The skin around her eyes

was puffy. And Ameera’s blood pressure

was indeed high, measuring 140/90.

(A healthy range for her age and height

is between 90/60 and 120/80.)

As she lay on her back on the exam

table, I felt her abdomen and located a

mass just above her right hip, toward

her back. She winced when I pressed it

softly. I had her sit up, then examined her

kidneys by pressing at the midback, just

above the hips. Everything there seemed

normal.

However, her urine test showed high

protein levels, which suggested nephrotic

syndrome, a kidney disorder. The disor-

der can also cause fluid to build up around

the eyes and ankles, as well as high blood

pressure. It explained nearly all her symp-

toms, but not the mass and the pain.

Surgery was the only way to get a

good look at the mass. We didn’t know

if it was affecting her ovaries or bladder,

so we needed a variety of specialists at

the operation.

SOMETHING AMISS

After starting the procedure, we were

shocked to find that Ameera’s mass —

large for her body, about the size of a plum

— seemed to grow out of her right ovary.

Then another shock: Ameera had no

left ovary. Instead, she had an underde-

veloped ovary — merely tissue — known

as a streak. She also had no uterus.

That combination of missing organs

is rare, and it had implications beyond

Ameera not being able to bear children:

Something may have gone awry in her

body’s development at the embryo stage.

Now came the hard work of figuring out

exactly what was ahead of us.

We took tissue samples of the kidneys

and the mass. Ameera did indeed have a

kidney disease, explaining her nephrotic

syndrome symptoms. And the mass

Growing Pains

Doctors find a surprising cause for a preteen’s

stomach pain and high blood pressure.

Life was changing fast for Ameera. She had moved with

her family thousands of miles from the Middle East to

Canada, and had just started school as a sixth-grader.

The 11-year-old was excited but also anxious, and she started

to complain of stomach pain. Eventually her parents took her

to their family doctor.

During the exam, the doctor discovered that Ameera’s blood

pressure was higher than it should have been for her age. So,

she ordered an ultrasound of her kidneys, since they help

regulate blood pressure. The test revealed she had a mass near

her right kidney, and she was referred to the local children’s

As she lay

on her back

on the

exam table,

I felt her

abdomen

and located

a mass just

above her

right hip,

toward

her back.

O«

VITAL SIGNS