Submitted CaseRPS/KUFA Satellite Symposium

Mar 2, 2008Denver, Colorado

Sheldon Bastacky

University of Pittsburgh

21-year-old HIV-positive man with a history of illicit drug use

• presents with renal failure 2 weeks after a sore throat. – Creatinine 4.5 mg/dl. – ASO, ANA, hepatitis B/C, ANCA - negative.– C3 98, C4 28.

• SPEP - no monoclonal immunoglobulin– cryoglobulin screen - not available

• urine protein - 2.5 gm/day

Summary of Findings

• endocapillary proliferative and exudative glomerulonephritis– Suggesting post-infectious GN.

• EM showed – subepithelial hump-like deposits– mesangial deposits, – a few subendothelial deposits – extensive podocyte foot process

effacement.

• IF positive for IgA rather than IgG

post-infectious GN versus IgA nephropathy?

Diagnosis: