U05-17286#790408400

82 yrs old male from EdmontonAdmitted with raising Cr 270, hemoptysis for 3 weeksProteinuria, hematuriaKnown to have:CKD base line Cr 150DM II Dx 15 years agoHTN COPDLung cancer S/P radiotherapy 1997(Lt Upper lobe)Colon cancer S/P surgery 1986HypothyroidismWBC 8 HB 90 Plate 188U/A protein +3 Hb +3 RBC 25-50 WBC 5-10P-ANCA +C3 0.26 (0.8- 2) C4 0.86 (0.18-0.36)CXRKidney Bx

IF• IgG- negative• IgA- negative• IgM- trivial to mild punctate mesangial staining• C3- mild mesangial staining• C1q- negative• Kappa- negative• Lambda- negative• Fibrin- mild interstitial staining• Albumin- negative

IgM

C3

Fibrin

Diagnosis:Renal Biopsy:Pauci-immune proliferative glomerulonephritis with crescent formation superimposed on mild diabetic nephropathy.