Digital Slide Seminar 4: Day 2 (09.30 - 10.00)
Tubulu-interstitial nephritis and vascular disease - Dr. Hanizah Khairan
Case 1: S6585/13 Hospital Seberang Jaya
29-year-old Malay man. Admitted with creat = 1808, urea = 53.2, proteinuria = 3.2g/day, no RBC, dialysis dependent. Autoimmune screening –ve, Hep B/Hep C/HIV screening –ve. Imp – chronic kidney disease (ESRD).
Case 2: R071/17 (Referred from Hospital Abdul Halim)
26-year-old Malay lady. SLE with lupus nephritis (biopsy in 2009).
Relapsed in 2016
Case 3: H7628/17 (Referred from Hospital Batu Pahat)
45-year-old Malay man. DM, generalised edema. Baseline creat (2016) – 98, creat 444, urea 23. UFEME – protein 1.5g/L, albumin 23. ANA 1:160 speckled.
Imp – nephrotic syndrome, TRO lupus.
Case 4: H9045/17 (Referred from Hospital Batu Pahat)
31-year-old Malay lady.
Case 5: RH12630/17 (2nd opinion from Clinical Haematology team)
45, Malay lady. Nausea, vomiting and epigastric discomfort on 06/01/2016 with 3/52 history of joint pain and lower back pain treated at KPJ Specialist Hospital. Previous history of taking traditional medication (TCM). Acute renal failure in Nov 2016 with proteinuria 8g. Renal biopsy done on 08/11/2016. Given prednisolone and cyclophosphamide. Kidneys echogenic but fairly normal sized. HD dependent until 21/11/2016.
Case 6: H8666/18
39, Chinese man. Myasthenia gravis on Aza + Pred. Nephrotic syndrome, AKI, oliguric and need CAPD. No malar rash, ulcer, arthralgia. 24hr urine volume 400ml. UFEME – protein 4+, blood 3+. ASOT –ve, ANA +ve (1:1320). Imp – ? RPGN, TRO diffuse proliferative lupus nephritis / crescentic GN.