U06-7465 #355924710 Proteinuria. 52 year old female followed for dextrocardia and Tetralogy of...
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Transcript of U06-7465 #355924710 Proteinuria. 52 year old female followed for dextrocardia and Tetralogy of...
![Page 1: U06-7465 #355924710 Proteinuria. 52 year old female followed for dextrocardia and Tetralogy of Fallot complicated by pulmonary hypertension and right.](https://reader035.fdocuments.in/reader035/viewer/2022062413/5a4d1b2f7f8b9ab05999a5f2/html5/thumbnails/1.jpg)
U06-7465#355924710
Proteinuria
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• 52 year old female followed for dextrocardia and Tetralogy of Fallot complicated by pulmonary hypertension and right heart failure. A valve repair ? commissurotomy had been done at age 12. Currently under evaluation for heart transplant listing vs repair of stenotic/ regurgitant Ao, mitral and pulmonary valves. Also noted asplenia.
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• Referred to evaluate proteinuria. NetCare records 1+ proteinuria intermittently for 3 years, with benign urine sediment and stable creatinine ~ 80 uM. 4 months prior to referral proteinuria quantitated at 400 mg/d.
• On evaluation Scr 79 uM. Urinalysis 1-5 rbc/hpf and P/Cr ~195 mg/mmol. Viral serology negative. SPEP, ANA, and complements normal.
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• IgG- negative, moderately high background• IgA- negative• IgM- mild mesangial staining• C3- strong vascular and mild vascular pole• C1q- negative• Kappa- moderate to strong background• Lambda- mild to moderate background• Fibrin- mild non-specific interstitial staining• Albumin- moderate diffuse background with some
glomerular accentuation (similar to the IgG, Kappa and Lambda)
IF
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IgM
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C3
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Fibrin
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Diagnosis:Renal Biopsy:
Focal segmental glomerulosclerosis withglomerulomegaly, secondary to cyanoticcongenital heart disease.
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