Slide Seminar 2 - May 2011
M S Ramaiah Medical CollegeKCIAPM SLIDE SEMINAR –NEPHROPATHOLOGY – 18th JUNE 2011
VENUE: M.S. RAMAIAH MEDICAL COLLEGE, BANGALORE
Moderator: Dr. Vijaya Mysorekar.
Case histories |
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CASE 1 A 28 year old male presented with the history of oliguria and bilateral swelling of limbs since 15 days. BP 200/130 mmHg. Investigations: Serum creatinine 7.9 mg/dL, serum albumin 1.7 gm/dL. Renal biopsy was done. |
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CASE 2 A 70 year old male presented with the history of anorexia and vomiting since one week. He was treated for pneumonia 15 days prior to this presentation. BP 110/80 mmHg. Investigations: Urine volume 1900 ml; urine protein 4071 mg/24 hrs; urine microscopy – WBCs 8-10/HPF, RBCs 40-50/HPF; serum creatinine 9 mg/dL. Renal biopsy was done. |
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CASE 3 A 31 year old male was diagnosed to have chronic myeloid leukemia. He was started on medication but discontinued it after 6 months and did not come for follow-up. Six months later, he developed anasarca, severe ascites and bilateral pleural effusion. BP 120/80 mmHg. Renal biopsy was done. |
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CASE 4 A 26 year old male who was a known hypertensive on irregular treatment, was admitted with the complaints of blurring of vision and headache since one month. BP 240/140 mm Hg, there was no oedema; peripheral pulses were felt. Investigations: Urine protein 3300 mg/24 hrs; serum creatinine 6.1 mg/dL. Renal biopsy was done. |
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CASE 5 A 25 year old female presented with the history of episodes of fever since the last 2 months. She also had bilateral pedal oedema. Investigations: Serum creatinine 1.4 mg/dL, urine protein 6800 mg/24 hrs. Renal biopsy was done. |
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CASE 6 A 48 year old male complained of pedal oedema and oliguria since 15 days. BP 140/90 mm Hg. Investigations: Serum creatinine 2.6 mg/dL, urine protein 3240mg/24 hrs. Renal biopsy was done. |
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CASE 7 A 14 year old male presented with pedal oedema and oliguria since one month. He had abdominal pain on and off. Investigations: Serum creatinine 0.6 mg/dL. Urine microscopy showed numerous RBCs. Urine protein 3900 mg/24 hrs. Renal biopsy was done. |
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CASE 8 Biopsy from a transplanted kidney in a 29 year old male. |
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CASE 9 A 28 year old male who had received a renal transplant one year back, had rising serum creatinine levels. There was history of drug defaulting. Transplant biopsy was done. |
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CASE 10 A 52 year old female underwent renal transplantation for end stage kidney disease. The donor was her husband. She received tacrolimus, mycophenolate mofetil and steroids prior to transplantation. Following the transplant, the urine output was good for 12 hours, after which she became oliguric (urine output 5–10 ml/hr) with rising creatinine. Her prothrombin time was prolonged. She underwent dialysis and renal biopsy. |
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FINAL DIAGNOSIS
CASE SEREIS NO 2
Case 01 | Focal and segmental glomerulosclerosis (NOS) with moderate tubular atrophy and moderate interstitial fibrosis |
Case 02 | Acute diffuse proliferative glomerulonephritis with crescent formation (post-infectious), with diabetes- induced changes and acute tubulointerstitial nephritis (severe degree) |
Case 03 | Membranoproliferative glomerulonephritis (MPGN) secondary to chronic myeloid leukemia, with chronic tubulointerstitial nephritis (mild degree) |
Case 04 | Crescentic and necrotising glomerulonephritis, pauci-immune, ANCA-associated, with acute tubulointerstitial nephritis (severe degree) and changes induced by malignant hypertension |
Case 05 | Diffuse proliferative and sclerosing lupus nephritis with membranous lupus nephritis - Class IV-G (A/C) + V. Activity index: 10/24, Chronicity index: 4/12 |
Case 06 | Renal amyloidosis with chronic tubulointerstitial nephritis (mild degree) |
Case 07 | Mesangioproliferative glomerulonephritis - Henoch Schönlein purpura |
Case 08 | Chronic active antibody-mediated rejection (transplant glomerulopathy-severe, interstitial fibrosis and tubular atrophy-moderate) Banff scoring for chronic changes – ci1, ct2, cg3, mm2, ti1, cv0, ah3 |
Case 09 | Acute cellular rejection Banff Type IA and IIB (g1, i2, t2, v2, ah0, cg0, ci0, ct 0, cv0) |
Case 10 | Calcineurin Inhibitor (tacrolimus)-induced thrombotic microangiopathy with early acute tubular injury |