Download - U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4
![Page 1: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/1.jpg)
U06-19814
#489287010
• 19 y.o. female with pneumonia creatinine
• proteinuria
• very low C3, C4
![Page 2: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/2.jpg)
• 19 year F transferred from High Level Hospital with Right Upper Lobe pneumonia, Anemia and ARF.
• 10 days prior to this admission patient had productive cough with fever.
• Symptoms worsen with time and with SOB, N and V was admitted to High Level Hospital.
• Treated with Cefotaxime and Azithromycin for URL pneumonia.
• Elevated serum Cr was presumed secondary to volume depletion and treated with IV Fluid (Cr decline from 220 to 140).
• In the ER at UAH patient needed more Oxygen and finally got intubated and admitted to ICU. Blood Culture positive for S. Pneumoniae.
![Page 3: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/3.jpg)
Lab: Day of admission: October 17,2006– C3: 0.23– C4: <0.05– Crea: 143 (stable around 130-140 on day 4)– Urea: 13– WBC: 5.8– Hgb: 80– Phos: 1.52– CK: 128– Pro/Crea: 428– Urine Microscopic: ? + RBC cast– IgG: 12.16– IgA: 2.11– IgM: .97– dsDNA: 28
Biopsy done in the ICU on 18-OCT-2006
![Page 4: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/4.jpg)
IF• IgG- Moderate to strong coarsely granular capillary loop
staining and mesangial staining. Moderate granular peritubular staining.
• IgA- Moderate coarsely granular capillary loop staining. • IgM- Moderate coarsely granular capillary loop staining. • C3- Moderate to strong coarsely granular capillary loop
staining. • C1q- Moderate coarsely granular capillary loop staining.
Moderate granular peritubular staining. • Kappa- Moderate coarsely granular capillary loop staining.
Mild granular peritubular staining.• Lambda- Moderate coarsely granular capillary loop staining.
Mild granular peritubular staining.• Fibrinogen- Mild interstitial staining. • Albumin- Negative.
![Page 5: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/5.jpg)
IgG
![Page 6: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/6.jpg)
IgG
![Page 7: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/7.jpg)
IgA
![Page 8: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/8.jpg)
IgM
![Page 9: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/9.jpg)
C3
![Page 10: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/10.jpg)
Clq
![Page 11: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/11.jpg)
Clq
![Page 12: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/12.jpg)
Kappa
![Page 13: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/13.jpg)
Kappa
![Page 14: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/14.jpg)
Lambda
![Page 15: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/15.jpg)
Lambda
![Page 16: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/16.jpg)
Fibrinogen
![Page 17: U06-19814 #489287010 19 y.o. female with pneumonia creatinine proteinuria very low C3, C4](https://reader035.vdocuments.net/reader035/viewer/2022070401/56649f1e5503460f94c367d1/html5/thumbnails/17.jpg)
DiagnosisRenal Biopsy:
• Diffuse lupus nephritis with global proliferative active lesions
• Class IV-G (A)