160 likes | 281 Views
U05-9799 #015016274755. 24 Year old female dx SLE April 2005 Complicated by thromboebolic events including DVT and extensive PE, AIHA, pulm. HTN March 2005 Treated in Fort Mac for CAP/ TB CT showed cavitary lung lesion, TB w/u negative
E N D
U05-9799 #015016274755 • 24 Year old female dx SLE April 2005 • Complicated by thromboebolic events including DVT and extensive PE, AIHA, pulm. HTN • March 2005 • Treated in Fort Mac for CAP/ TB • CT showed cavitary lung lesion, TB w/u negative • Had open lung Bx for cavitating lung disease – thromboembolic arteripathy c/w SLE and evidence pulm.HTN • Anti-dsDNA, ANCA neg, ANA pos, HIV/Hep C neg • C3/C4 0.031/0.03 (Low) • P:C 96.67, Cr 30 • Followed by Dr. Aaron and given steroids/plaquenil • May 2005 –Readmitted to hospital for CAP and ? nephrotic syndrome • Cr 48, Alb 22, P:Cr 415.63, LDL1.28, U/A -1-5 RBC, 3+ prot, 0 HB (sg 1.031) cytodiag occ. Heme gran casts, wbc casts • O/E BP 121/80, JVP N, 3+ pitting edema
IF • IgG- Moderate mesangial staining • IgA- Mild-moderate mesangial staining • IgM- Moderate mesangial staining • C3- Mild mesangial staining • C1q- Moderate mesangial and vascular staining • Kappa- Mild mesangial staining • Lambda- Moderate mesangial staining • Fibrin- Moderate interstitial staining • Albumin- Mild hyalen droplet change in tubular cytoplasm
Diagnosis:Renal Biopsy:Mesangial proliferative lupus nephritis of mild activity and no chronicity