Slide Digitization by:
Digital Slide Seminar 3: Day 1 (16.30 - 17.00)
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Nephritic syndrome - Dr. Nik Hasimah Nik Yahya​ ​
Case 1: 31 yr old male
•Bilateral leg swelling, abdominal distension and frothy urine x 2 weeks
•24hr urine protein 9gm
•Sr albumin : 14
•HepB/C, ANA : negative
•Creatinine : normal
•UFEME : Prot ++, RBC +
•IF: IgA(3+), C3(1+), mesangial area.
IgG, IgM and C1q are negative.
Case 2: 23 yr old male
•No known medical illness
•Noted proteinuria on medical check-up
•24hr urine protein : 3.12gm
•Creatinine : 112μmol/l
•UFEME : Protein3+, RBC+
•IF : IgA(2+) and C3(+/-) in mesangium. IgG, IgM and C1q are negative.
Case 3: 4 yr old male
•Abdominal pain, purpuric lesion both lower limbs.
•Generalised eodema
•Macroscopic haematuria
•Nephrotic range protenuria
•Creatinini : 324μmol/l
•UFEME : Protein3+, blood3+
•IF : IgA(3+) with prominent capillary wall pattern. IgM(1+) and C3(+/-).
IgG and C1q are negative.
Case 4: 36 yr old female
•SLE since 2015
•First renal biopsy done in 2016, reported as class IV. Treated.
•Now present with generalised swelling and body rash.
•Creatinine 300μmol/l
•? Relapse lupus nephritis
•IF: Positive(3+) for IgG, IgA, IgM, C3 and C1q.
Case 5: 24 yr old female
•Facial puffiness, bilateral LL oedema and ascited
•Noted hypertension
•UFEME: Protein 4+, RBC 1+
•Creatinine: 299μmol/l
•C3 : low
•ANA, ASOT : Negative
•HepB, HepC and HIV : Negative
•IHC: Positive for C3, IgM and C1q. IgG and IgA are negative.
Case 6: 61 yr old lady
•Unwell for a few weeks
•Taking traditional medicine
•Hepatitis C +
•DsDNA+, ANA negative
•IF : No glomeruli
•IHC: IgG, IgM and C3. IgA and C1q are negative
Case 7: 12 yr old boy
•Cough, sore throat and fever 3 weeks
•Nephritic syndrome
•Dark coloured urine
•UFEME : RBC +++ Protein +++
•Creatinine : 400
•Serum albumin 25
?RPGN
IF : IgG(1+), C3(2+); granular along the capillary wall. IgA, IgM and C1q are negative.
Case 8: 44 yr old lady
•Nephrotic-nephritic syndrome.
•UFEME : Protein 2+, RBC3+
•24 hr urine prot : 2.6gm
•Albumin : 30
•Creatinine : 68μmol/l
•ANA, HepB/C, HIV are all negative
•IF: C3(3+) granular in mesangial and capillary wall. IgG, IgA, IgM and C1q
are negative.
Case 9: 45 yr old lady
•Unwell for 1 month
•Presented with acute kidney injury
•Creatinine : 415
•UMEFE : RBC++, Protein +
•pANCA positive
•IF: IgG, IgA, IgM, C3 and C1q are all negative.
Case 10: 15 yr old girl
•SLE
•Nephrotic range proteinuria
•Creatinine 120μmol/l
•Low C3 and C4
•IF: IgG(2+), IgA(2+), IgM(2+), C3(3+) and C1q(3+); capillary wall and mesangium