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U06- 24140

U06- 24140. #951523110 Creat 100 May 06  now 900 Has ~ 3 g protein Trace hematuria.

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U06- 24140

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  1. U06-24140 #951523110 • Creat 100 May 06  now 900 • Has ~ 3 g protein • Trace hematuria

  2. 54 yr old femalepresented with : L.L edema , nausea , fatigueMarch 06: urine : trace ptn, trace Hb , ptn/cr 157Mid Dec 06 : s.Cr: 960 , urine: 2+ptn, 2+ Hb, 1+ WBC C3, C4, ANA, ANCA, Anti-GBM, cryo : -ve +ve Bence Jones ptns in urine SPEP: free kappa light chain near Gamma region(1 gm/l) , background hypogammaglobulinemia Hb: 110, WBC: 10.2, Plts: 322

  3. IF • IgG-Negative. • IgA-Negative. • IgM-Negative. • C3- Mild vascular staining. • C1q-Negative. • Kappa- Moderate staining of tubular casts. Mild to moderate tubular basement membrane staining. • Lambda-Negative. • Fibrinogen- Mild to moderate interstitial staining. • Albumin- Mild to moderate linear TBM staining.

  4. C3

  5. Kappa

  6. Kappa

  7. Kappa

  8. Fibrin

  9. Albumin

  10. EM • pending

  11. DiagnosisRenal Biopsy: • Kappa light chain cast nephropathy with extensive glomerulosclerosis of unknown etiology and tubular injury, with striking interstitial infiltrate of eosinophils • Rule out allergic interstitial nephritis

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