u78-5672 id:434500-5

17
U78-5672 ID:434500-5 A 4-year-old girl had persistent hematuria (microscopic) found by routine urinalysis. Patient has been symptom free. Been investigated with no good information revealed. Probable diagnosis Focal glomerulonephritis.

Upload: abbot-delgado

Post on 04-Jan-2016

38 views

Category:

Documents


0 download

DESCRIPTION

U78-5672 ID:434500-5. A 4-year-old girl had persistent hematuria (microscopic) found by routine urinalysis. Patient has been symptom free. Been investigated with no good information revealed. Probable diagnosis Focal glomerulonephritis. IF. IgG –Negative. IgA –Negative. IgM –Negative. - PowerPoint PPT Presentation

TRANSCRIPT

Page 1: U78-5672 ID:434500-5

U78-5672 ID:434500-5

A 4-year-old girl had persistent hematuria (microscopic) found by routine urinalysis. Patient has been symptom free. Been investigated with no good information revealed. Probable diagnosis Focal glomerulonephritis.

Page 2: U78-5672 ID:434500-5
Page 3: U78-5672 ID:434500-5
Page 4: U78-5672 ID:434500-5
Page 5: U78-5672 ID:434500-5
Page 6: U78-5672 ID:434500-5
Page 7: U78-5672 ID:434500-5

IF

• IgG –Negative.

• IgA –Negative.

• IgM –Negative.

• C3 –Negative.

• Fibrinogen –Negative.

Page 8: U78-5672 ID:434500-5
Page 9: U78-5672 ID:434500-5
Page 10: U78-5672 ID:434500-5

Interpretation

• The minimal findings are compatible with “idiopathic (essential) hematuria” or with “benign familial hematuria”.

• Persistent “fetal type glomeruli” are a feature of early cases of “Alport’s syndrome”, these can be seen in infantile kidneys with persistent fetal lobulation of the cortex.

• The absence of focal proliferative changes in glomeruli mitigates against a diagnosis of focal glomerulonephritis.

Page 11: U78-5672 ID:434500-5

DIAGNOSIS

• Needle biopsy of kidney showing a few persistent “fetal Glomeruli” renal glomeruli and occasional red cell casts within renal tubules.

Page 12: U78-5672 ID:434500-5

EM82-5343

Glomerulonephritis (open renal biopsy).

Page 13: U78-5672 ID:434500-5

IF

• IgG – Negative.

• IgA – Negative.

• IgM – Negative.

• C3 – Negative.

• Properdin – Negative.

Page 14: U78-5672 ID:434500-5
Page 15: U78-5672 ID:434500-5
Page 16: U78-5672 ID:434500-5
Page 17: U78-5672 ID:434500-5

DIAGNOSIS

• Probable “Progressive Hereditary Nephritis” (Alport’s syndrome).