30yrs old male patient in our nephro ward jj hospital, patient had b/l pedal edema, low back pain radiating to foots, systolic bp always below 100mmhg Investigation creatine- borderline high ANA- positive dsDNA- positive C3 ,C4- decreased 24hrs urine protein- 1 GM usg- normal kidney sizes URM- had UTI but now resolved Renal biopsy done - sample send for LM, IF, EM reports awaited we start tab Prednisone and tab MMF we are suspecting as case of glomerulonephritis, what further treatment will require ??, because his edema is not resolved..

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Expected biopsy report shud be: Focal Proliferative glomerulonephritis, Lupus Nephritis WHO Class III. He shud have been started on IV solumedrol followed by prednisolone n MMF. For persisting edema, employ fluid restriction n diuretic. Consider IV albumin if inadequate response. Dialysis will be the last option

plz notify when biopsy report available.
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All history and investigations suggest Lupus Nephritis.....class V Nephritis - dt is a poor prognosis... Start Cyclophosphamide and see the response.... Tab Mycophenolate Mofetil if relapse occurs....

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Thanks for the appreciation..
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renal biopsy report gives final diagnosis as Membranous grade 5 and Focal grade 3 Lupus Nephritis with some crescents Sothat now we stop tab MMF temporaryly And we start Inj endoxan of 3 cycles after that we start tab MMF as a maintenance

Thanks
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Thanks for sharing to this case sir 1. TSH level?? 2. Urea level 120mg% so its possibilities to near abt ARF..!! 3. Hypoalbuminemia 4. Please share biopsy reports soon

Biopsy report gives final diagnosis as Membranous grade 5 and focal grade 3 Lupus Nephritis withe some crescents present@Curofy
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?Lupus nephritis ..pedal edema may be hypoalbuminemia plus aki ...what is the urine output?

I think it could be a case of lupus nephritis. I wonder if we could also add an ACE inhibitor and a loop diuretic. Please post the biopsy report too sir once obtained.

Biopsy report attached in case history check it
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Thanks for sharing this case lot of learning Thanks de sunil bhosle sir and curofy

It's pleasure to me to share such a interesting cases
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It is a Nephrotic Syndrome.fluids inj lasix4 amp stat.appropriate antibiotic b complex

Biopsy report shows it's lupus nephritis
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Seems to be Type II or immune complex mediated RPGN ? with nephritic range/ARF proteinuria , supported by evidence of SLE and low C3. I suppose , biopsy to be done?? , mean while steroid therapy to be initiated. Sir pls update us with followup for this case

Biopsy report shows it's Membranous grade 5 and focal grade 3 Lupus Nephritis
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