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Upstate Medical university Case Study

Getting Over the Hump (return to case list)

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A 26 year-old man with no past medical problems was in good health until about one week ago when he had a sore throat. He was given an antibiotic at an urgent care clinic but 3 days later began to have ankle swelling. On evaluation now he has fever (38.2 C), BP 134/64 mm Hg, HR 76/min, normal JVP, mild pitting ankle edema, no rash, lungs clear, proteinuria (2+; urine protein/creatinine ratio 0.27), hematuria (3+; 25-50 RBC/HPF), renal insufficiency (serum creatinine 1.7 mg/dl), hypocomplementemia (low C3 at 23 mg/dl [90-180] and normal C4 at 30 mg/dl [10-40]

1. Summarize the renal presentation (select from List 1).

A renal biopsy was performed.

Pathology Report for Biopsy

Case V Biopsy Thumbnail Image 1
Slide 1
Case V Biopsy  Thumbnail Image 2
Slide 2
Case V Biopsy Thumbnail Image 2
Slide 3
Case V Biopsy Thumbnail Image 2
Slide 4

All of the glomeruli were similar to that shown in Slide 1. Immunofluorescence is shown in Slide 2 and electron micrographs in Slides 3-4.

2. What is the pathologic diagnosis (select from List 2).
3. What is the probable final clinico-pathologic diagnosis?