1 / 18

U06- 20274

U06- 20274. #324676110 Creat 250 Nephritic urine ? Crescentic GN. 54-year old Caucasian male. CC: Leg Edema, Skin Rash, Leg Pain and hands numbness.

colt-hewitt
Download Presentation

U06- 20274

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. U06-20274 #324676110 • Creat 250 • Nephritic urine • ? Crescentic GN

  2. 54-year old Caucasian male • CC: Leg Edema, Skin Rash, Leg Pain and hands numbness. • HPI: 8 Wks prior to admission he noticed leg edema and rash. Treated with Cephazolin and cephalexin for few days for cellulitis. No URI, No Fever, No gross hematuria, No Sore throat. • PMH: Asthma (using combivent PRN)

  3. Labs: (on admission) • Hgb: 132 • Cr 247 (Baseline Cr: 110) • U/A: SG of >1.030 • Pro/Crea: 314.00 • ALT, AST and Alk.Pho: NL • dsDNA: Neg, • RF(Sep2006): 22 • ANA: NEG • p-ANCA and c-ANCA: NEG X 2 • C3 and C4: 1.33 and .91

  4. Kidney Biopsy on 25-OCT-06 ?

  5. IF • IgG-Negative. • IgA- Moderate irregular peripheral lobular finely granular staining. • IgM-Negative. • C3- Moderate irregular peripheral lobular staining. Moderate vascular staining. • C1q-Negative. • Kappa-Negative. • Lambda-Negative. • Fibrin- Mild interstitial staining. • Albumin-Negative.

  6. IgA

  7. IgA

  8. IgA

  9. IgA

  10. C3

  11. C3

  12. Fibrin

  13. EM • Will be ready in the coming weeks.

  14. DiagnosisRenal Biopsy: • Focal proliferative GN with peripheral lobular granular staining for IgA and possible arteriolitis with necrotizing changes. • Rule out Henoch-Schönlein purpura. Comment: the IF pattern is unusual but has been described in Henoch-Schönlein purpura.

  15. Series of 10 paediatric cases • A/a focal and segmental hypercellularity with # monocytes • IgA deposits at periphery of lobules, not in mesangium • Early phase of disease ? • 3/6 subsequent biopsy was normal (with no IgA deposition) • 3/6 subsequent biopsy with mesangial IgA

More Related