1 / 18

Lupus Nephritis: Membranous Lupus Nephritis Mixed with Focal Lupus Nephritis (Class V and IIIA)

This case study describes a 28-year-old Nigerian-Canadian with symptoms of intractable nausea and vomiting, bilateral flank pain, fever, and feeling unwell. After several tests and treatments, a renal biopsy confirmed the diagnosis of lupus nephritis, with a combination of membranous lupus nephritis (Class V) and focal lupus nephritis with active lesions (Class IIIA).

fsullivan
Download Presentation

Lupus Nephritis: Membranous Lupus Nephritis Mixed with Focal Lupus Nephritis (Class V and IIIA)

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. U06-3222 #657376720 28yo Nigerian Canadian, born in Toronto HPI Presented with a several day history of intractable N&V, bilateral flank pain, fever and generally feeling unwell. Was seen in ER. Cr was normal and U/A showed 6-10 WBC, 26-50 RBC and occasional granular and hyaline casts. He was referred to Dr. Bradley who initiated a GN work-up. In the interim, the N&V continued and he was admitted to hospital a few days later. Cr remained normal. CK increased to > 500, and urine was + for myoglobin so he was treated for rhabdomyolysis. Several days following admission he acutely developed peripheral edema and ascites, N&V remain intractable. 48 hours following this, Cr began to rapidly increase from 80 - ~ 550.

  2. U06-3222 #657376720 PMH: nil Abdominal U/S: increased renal echogenicity, edema of the bowel, ascites CT abdomen: Bowel wall edema Cr: 550, electrolytes N, CBC N ANCA, Ds-DNA, C4, protein electrophoresis = normal ANA +, IgA & IgG increased, C3 0.57, albumin 19 PE: mild hypertension, ascites, peripheral edema, decreased perianal and scrotal sensation, mild incontinence of stool and urine No skin or MSK abnormalities

  3. IF • IgG-Strong coarsely granular capillary loop staining • IgA- Mild to moderate coarsely granular capillary loop staining • IgM- Mild coarsely granular capillary loop staining • C3- moderate coarsely granular capillary loop staining • C1q- mild to moderate coarsely granular capillary loop staining • Kappa-moderate coarsely granular capillary loop staining • Lambda- moderate coarsely granular capillary loop staining • Fibrin- Mild interstitial staining • Albumin- mild hyaline droplet change in tubular cytoplasm

  4. IgG

  5. IgA

  6. IgM

  7. C3

  8. Clq

  9. Kappa

  10. Lambda

  11. Fibrin

  12. Albumin

  13. Diagnosis:Renal Biopsy Lupus nephritis Class V ,Membranous lupus nephritis mixed with focal lupus nephritis Class IIIA with active lesions (2003 ISN/RPS Classification).

More Related