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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I enjoyed the review of chronic renal insufficiency by Rahman and Smith,¹ but found the omission of one cause of renal insufficiency to be disheartening. Herein I describe a case of nephropathy whose cause was only discovered only after the physician was guided by a subtle laboratory finding to question the patient carefully about her medical and social history.

Report of a Case.

A 21-year-old African American woman was sent to an internist for evaluation. The patient had seen her gynecologist for birth control management, and after considering all options, chose tubal ligation. She was in good health with no known chronic illnesses and taking no medication. She had 2 children, both in good health, and results of a physical examination were normal. Her preoperative urinalysis revealed 3+ proteinuria, and she was referred for evaluation of the proteinuria. On further review by the internist of the complete laboratory report, it was noted that the . . . [Full Text of this Article]

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