U06-130#16937856102

19 year old femaleArtheritis with increased creatinine, proteinuria, hematuria.? Lupus

21yrs old female   Presented with arthralgias associated with an elevated serum creatinine. Symptoms began immediately after a (second) therapeutic abortionCreatinine 189 U/A +3 protein ,WBC  26-50 ,RBC 11-25,Protein/Cr  227 mg/mmole, Albumin 19 Hb 79   plat 168 WBC 3.9Anti DNA +ANA  +C3  &    C4  Low

IF• IgG- Moderate to strong coarsely granular capillary

loop staining, moderate granular peritubular staining• IgA- Moderate coarsely granular capillary loop staining• IgM- Negative• C3- Moderate coarsely granular capillary loop staining,

moderate granular peritubular staining• C1q- Moderate coarsely granular capillary loop

staining, mild to moderate granular peritubular staining

• Kappa- Mild to moderate coarsely granular capillary loop staining, mild to moderate granular peritubular staining

• Lambda- Same as kappa • Fibrin- Mild to moderate interstitial staining• Albumin- Mild to moderate hyaline droplet change in

tubular cytoplasm

IgG

IgG

IgA

C3

C3

Clq

Clq

Kappa

Kappa

Lambda

Lambda

Fibrin

Albumin

Diagnosis:Renal Biopsy:Diffuse global proliferative lupus nephritis (Class IV-G (A), 2003 ISN/RPS Classification) with moderate activity and mild chronicity.