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U05-17286#790408400 82 yrs old male from EdmontonAdmitted with raising Cr 270, hemoptysis for 3 weeksProteinuria, hematuriaKnown to have:CKD base line Cr 150DM II Dx 15 years agoHTN COPDLung cancer S/P radiotherapy 1997(Lt Upper lobe)Colon cancer S/P surgery 1986HypothyroidismWBC 8 HB 90 Plate 188U/A protein +3 Hb +3 RBC 25-50 WBC 5-10P-ANCA +C3 0.26 (0.8- 2) C4 0.86 (0.18-0.36)CXRKidney Bx
IF • IgG- negative • IgA- negative • IgM- trivial to mild punctate mesangial staining • C3- mild mesangial staining • C1q- negative • Kappa- negative • Lambda- negative • Fibrin- mild interstitial staining • Albumin- negative
Diagnosis:Renal Biopsy:Pauci-immune proliferative glomerulonephritis with crescent formation superimposed on mild diabetic nephropathy.