clinical chemistry case study - proteins

7/24/2019 Clinical Chemistry Case Study - Proteins

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A 40-year-old Woman who

has been Feeling Lethargic

PROTEI

!ayam" !lydenne !laire P#


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$ase Problem

%&dy" a 40-year-old woman with a 'ast

history o( )idney in(ections" was seen by

her 'hysician beca&se she had been

(eeling lethargic (or a (ew wee)s# *he also

com'lained o( decreased (re+&ency o(

&rination and a bloated (eeling# The

'hysician noted 'eriorbital swelling and

general edema" incl&ding a swollen


3/8

Laboratory Res&lts,

rinalysis

Macroscopic

$olor .ellow

Appearance Cloudy or frothy

*'eci/c !raity 1#022

'3 #0Protein 3+ (500mg/dL)

(A! "+)!l&cose eg

5etones eg

6ilir&bin eg

6lood eg

robilinogen ormal

itrite eg

Le&)ocyte

Esterase

eg

Microscopic

W6$s 0-783PF

R6$s 0-183PF

E'ithelial$ells

Rare s+&amo&s83PFRare renal t&b&lar

e'ithelial83PF$asts 0-7 3yaline8LPF

1# Renal T&b&lar

e'ithelial83PF

2# !ran&lar8LPF

7# Wa9y8LPF

0#$ %atty/LP%

Other &ccasional o'al fat

odies


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Laboratory Res&lts, $hemistry

eference ange

Protein :#0 g8dL ;#0-


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1#What ty'e o( disease or

condition wo&ld becharacteri>ed by the&rinalysis and chemistry

res&lts?

*ephrotic syndrome mar)ed 'rotein&ria and li'id&ria

@oal (at bodies and (atty casts in&rinalysis

3y'oalb&minemia and


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2# Bisc&ss the 'hysiological ca&se o(edema#

dema

ca&sed by hy'oalb&minemia

which leads to red&ced'lasma osmotic 'ress&re@allows C&id to lea) (rom

blood essels to the intestinals'aces#


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7# What is %&dyDs alb&min,glob&lin @A,!ratio? Is it within the re(erence range? Is

it consistent with the 'robable diagnosis?

%&dyDs A,! ratio is 0,-." which is belowthe re(erence range @1#:-7#:# ormalalb&min leels are ;0 o( the total'rotein# A low A,! ratio is consistent witha diagnosis o( ne'hrotic syndrome#Total *er&m Protein Alb&min G !lob&lin! TP - A

! :#0 g8dL H 2#4 g8dL 2#; g8dLA,! 2#4 g8dL , 2#; g8dL

A,! 0#2


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4# Bescribe what yo& wo&ld e9'ectto see in this 'atientDs 'roteinelectro'horesis#

*ephrotic yndrome P mar)edly increase in J2- and K-

glob&lins

mar)edly decrease alb&min and-glob&lins" es'ecially Ig!

clinical chemistry case study - proteins

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