u05-9799 #015016274755

U05-9799 #015016274755•24 Year old female dx SLE April 2005•Complicated by thromboebolic events including DVT and extensive PE, AIHA, pulm. HTN•March 2005

–Treated in Fort Mac for CAP/ TB –CT showed cavitary lung lesion, TB w/u negative–Had open lung Bx for cavitating lung disease – thromboembolic arteripathy c/w SLE and evidence pulm.HTN–Anti-dsDNA, ANCA neg, ANA pos, HIV/Hep C neg–C3/C4 0.031/0.03 (Low)–P:C 96.67, Cr 30–Followed by Dr. Aaron and given steroids/plaquenil

•May 2005 –Readmitted to hospital for CAP and ? nephrotic syndrome–Cr 48, Alb 22, P:Cr 415.63, LDL1.28, U/A -1-5 RBC, 3+ prot, 0 HB (sg 1.031) cytodiag occ. Heme gran casts, wbc casts–O/E BP 121/80, JVP N, 3+ pitting edema

IF• IgG- Moderate mesangial staining• IgA- Mild-moderate mesangial staining• IgM- Moderate mesangial staining• C3- Mild mesangial staining• C1q- Moderate mesangial and vascular staining• Kappa- Mild mesangial staining• Lambda- Moderate mesangial staining• Fibrin- Moderate interstitial staining• Albumin- Mild hyalen droplet change in tubular

cytoplasm

IgG

IgA

IgM

C3

Clq

Clq

Kappa

Lambda

Fibrin

Albumin

Lambda

Kappa

Diagnosis:Renal Biopsy:Mesangial proliferative lupus nephritis of mild activity and no chronicity