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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+

 

 

 

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

 

 

 

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

 

 

 

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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