226757920 u06-2835 lupus.nephrotic syndrome now. normal creat. c3/c4, ana +, ? membranous...
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226757920U06-2835
Lupus.Nephrotic syndrome now. Normal creat.C3/C4, ANA +,? Membranous ?antiphospholipid Ab syndrome
226757920U06-2835
42 Yr Female with diagnosis of SLE On prednisone 7.5mg/d, Hydroxy- chloroqiune 200mg/d for control of Systemic features. Referred for Proteinuria 2 yrs ago. Creatinine 70-80 umol/l. protein 300-500mg/d Last visit edema(new onset) Creatinine 80umol/5grams proteinuria Albumin 28g/L C3 0.58 C4 0.04 ANA+ve, anti DNA 76( baseline 15-30) ENA -ve UA 3+ protein MIC 25-50 WBC's 11-25 RBCs.. HB 113-116 Haptoglobin 3.22 LD 185 FOB -ve Ferritin 54???? D/D Membranous Mixed
• IgG- moderate to strong coarsely granular capillary loop staining
• IgA- moderate coarsely granular capillary loop staining• IgM- moderate coarsely granular capillary loop staining• C3- mild to moderate coarsely granular capillary loop
staining/ mild mesangial staining• C1q- mild to moderate coarsely granular capillary loop
staining/ mild mesangial staining• Kappa- inadequate tissue• Lambda- moderate coarsely granular capillary loop
staining• Fibrin- moderate interstitial staining• Albumin- mild hyaline droplet change in tubular
cytoplasm
IF
IgG
IgA
IgM
C3
Clq
Lambda
Fibrin
Albumin
Diagnosis:Renal Biopsy:Lupus nephritis.
(A)Membranous and focal Proliferative Glomerulonephritis Pattern.
(B)Moderate Activity (NIH score 8/24) and Low Chronicity (1/12).