Digital Slide Seminar 2 : Day 1 (14.15 - 14.45)
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​​​Hematuria and asymptomatic proteinuria - Dr. Fauzah Abdul Ghani
Case 1:
- 70-year-old male
- Background 1. Hypertension on treatment 2. Hepatitis B with liver cirrhosis
on Tenofivir.
- Haematuria + nephrotic range proteinuria
- Cr 239, UPCI 9.2g, HepBs Ag reative, HepC/HIV negative.
- Albumin 10
- IMF: IgM focal weak, non-specific
- IgG, IgA, C3, C1q are negative
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Case 2:
- 23-year-old lady
- Asympatomatic proteinuria & haematuria referred from Urology.
- No frothy or tea coloured urine. No lower limb swelling.
- C3 & C4 normal. ANA not sent. Albumin 32, Creatinine 70.
- HepB/HepC/HIV – NR. UPCI 1.4g → 1.7g
- Urine FEME Blood 2+, Protein 2+
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Case 2 - HE
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CASE 2 - C3
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CASE 2 - Ig6
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CASE 2 - IgA
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CASE 2 - IgM
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CASE 2 - MT
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CASE 2 - PAAG
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CASE 2 - PAS
Case 3:
- 13-year-old boy Form 3 student from boarding school (Perlis)
- Presented to Hospital Putrajaya for bullous skin lesion x 2/52 → facial swelling &
abdominal distension x 3/7. Tea coloured urine x 3/7. Completed x 1/52 of
cloxacilin. BP 134/76
- Urine FEME Blood 5+, Protein 4+, UPCI 7.1g → 5.8g.
- Creatinine 574 (downgoing trend), Albumin 25, ASOT negative.
- HepB/HepC/HIV – NR, WBC 13.1 (79% neutrophils).
- ANA indeterminate, C3 low, C4 normal.
Case 4:
- 63-year-old male with nephrotic syndrome + haematuria.
- Background Hypertension. No diabetes.
- ?FSGS ?IgA ?Amyloid
- IMF are all negative
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CASE 4 - FIBN
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CASE 4 - GMS
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CASE 4 - PAS
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Case 4 - EM Image-MK41
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Case 4 - EM Image-MK43
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Case 4 - EM Image-MK44
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Case 4 - EM Image-MK46
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Case 4 - EM Image-MK47
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Case 4 - EM Image-MK50
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Case 4 - EM Image-MK51
Case 5:
-65-year-old lady with haematuria. (1+)
- Normal renal function.
- Vasculitic screen negative.
- ?diabetic nephropathy ?amyloid ?FSGS ?membranous
- IMF: IgG (2+), Kappa LC (, C3(1+) within mesangium and capillary wall. IgG, IgM
and C1q, lambda LC are negative
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Case 5 - HE
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CASE 5 - GMS
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CASE 5 - PAS
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Case 5 - EM Image-MK01
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Case 5 - EM Image-MK02
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Case 5 - EM Image-MK03
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Case 5 - EM Image-MK04
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Case 5 - EM Image-MK05
Case 6:
- 56-year-old male with haematuria + proteinuria <1g/day
- Background 8 years history of diabetis & hypertension.
- No microvascular complication.
- ?IgA nephropathy
- IMF: mesangium, IgG (3+), IgA (1+), IgM (1_), C3 (1+), C1q (2+), Kappa LC (3+),
Lambda LC ,(3+)
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Case 6 - HE
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Case 6 - MASST
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Case 6 - EM Image-MK24
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Case 6 - EM Image-MK28
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Case 6 - EM Image-MK31
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Case 6 - EM Image-MK35
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Case 6 - EM Image-MK36