CASE OF THE MONTH- MARCH 2023

Case Contributed by: Dr Tushar Toprani, Vadodara

CASE HISTORY:

• F/54 years
• C/o dyspnea on exertion, on and off pedal oedema and generalized weakness since 1 month
• K/c/o HT, Hypothyroidism since 4-5 years – on regular treatment
• No other major illness like Diabetes
• Investigations - Hb 8.1, normal WBC and platelet count, Insidiously rising S Creat (presently 2.0), Urine routine +4 protein, absent RBCs, casts ++, Urine protein 9.2 gm/ gm Creat, S. Chol 143.5, Normal S. Protein, Albumin, Normal C3, ANA negative, HIV/HbsAg/HCV negative
• Biopsy for proteinuria and renal dysfunction 

MCQs
​
1. Based on the above, what further would you like to do to make the diagnosis?  
A. More History
B. Further Stains / Immunofluorescence
C. Immunohistochemistry
D. Electron Microscopy  

2. What are probable differential diagnosis?  
A.  IgA nephropathy
B.  Infection associated glomerulonephritis
C.  Deposition diseases (amyloid/fibrillary/immunotactoid)
​D. Lupus nephritis