Dappmc - Araral, Maxine - PX Data & Case Def

CHAPTER II
PATIENT’S DATA
Patient’s Information Seriously ill 40-year-old man

Several episodes of macroscopic hematuria in the past 20
Patient’s Complaints years associated with exercise or stress
and Manifestation Recently the macroscopic hematuria had spontaneously
reverted to asymptomatic microscopic hematuria
URINALYSIS
Tests Results
PHYSICAL EXAMINATION
Color Red
Clarity Slightly cloudy
CHEMICAL EXAMINATION
pH 6.5
Specific Gravity 1.010
Blood Large
Ketones Negative
Bilirubin Negative
Urobilinogen Normal
Protein 300 mg/dL
Nitrite Negative
Glucose 250 mg/dL
Leukocyte Trace
MICROSCOPIC EXAMINATION
Red Blood Cells >100 RBC/HPF
White Blood Cells 8-10 WBC/HPF
Casts 2-4 Hyaline casts/LPF
1-5 Granular casts/LPF
0-2 Waxy casts/LPF
0-2 Broad casts/LPF
CLINICAL CHEMISTRY
Tests Results
BUN 80 mg/dL
Serum Creatinine 4.5 mg/dL
Creatinine Clearance 20 mL/min
Serum Calcium 8.0 mg/dL
Serum Phosphorous 6.0 mg/dL
SEROLOGY
Tests Results
Serum IgA elevated
CHAPTER III
A. CASE DEFINITION
The case given was about a seriously ill 40-year-old man with a history of several episodes
of macroscopic hematuria in the past 20 years. The episodes were associated with exercise or
stress. Until recently, the macroscopic hematuria had spontaneously reverted to
asymptomatic microscopic hematuria. The presence of blood in a person's urine is known as
hematuria. Gross or When an individual can see the presence of blood in the urine, this is
known as macroscopic hematuria. When the blood is seen under the microscope by a medical
professional, this is known as microscopic hematuria. The presence of red blood cells in the
urine may originate from the kidney or other lesions that may obstruct the urinary tract,
raising intrarenal pressures and causing impairment of kidney function. Therefore, the case
given is correlated to kidney disease.
Glomerular illnesses encompass a wide range of ailments with numerous causes.

Immunoglobulin A Nephropathy, also known as Berger's disease or IgAN for short, is a
condition that affects the glomeruli inside your kidneys and can lead to kidney disease.
Immunoglobulin A is a protein that aids your body's defense against infections. IgA
nephropathy develops when IgA protein lodges in the kidneys, producing inflammation. The
inflammation causes your kidneys to leak blood and protein (typically instantaneously), the
same as what the patient has been manifesting. The kidneys can lose their function over time,
eventually leading to renal failure.
A specific and significant test for diagnosing IgA Nephropathy is through examining the
levels of Immunoglobulin. In this case, the patient shows an elevated level of Immunoglobulin
A. Researchers does not know precisely the cause of IgA deposits in the kidneys. Still, the
following may be associated with hereditary variables that may play a role in producing the
disease because IgA nephropathy is more common in specific families and ethnic groups. The
disease appears to be prevalent in particular families and geographical locations in certain
situations. It is uncommon for African heritage. The patient's age was also close to the range
of age groups where this condition most commonly manifests itself, which is between the late
teens and late 30s.
In addition, laboratory results from Clinical Chemistry include a highly elevated level of
BUN of (80 mg/dL), serum creatinine of (4.5 mg/dL), and serum phosphorous (6.0 mg/dL).
These elevated BUN, creatinine, and phosphorous levels can indicate kidney issues because in
a healthy body, the kidney balances and removes wastes. Still, when kidney function
decreases, these can elevate the mentioned tests. At the same time, tests for creatinine
clearance of (20 mL/min) and serum calcium of (8.0 mg/dL) show decreased results and can
also be correlated to kidney disease. Patients with renal disease have a reduced ability to
produce active vitamin D. Without enough active vitamin D, there is less absorption of calcium
from the eaten food, resulting in a calcium deficiency in the blood.
Another important laboratory test which is urinalysis was done on the patient. Urine
physical examination reveals a red color and slightly hazy urine. Upon chemical examination,
the patient's urine has a pH of 6.5, a specific gravity of 1.010, negative for ketone, large
grading for blood, negative for bilirubin, normal level for urobilinogen, 300 mg/dL of protein,
negative for nitrite, 250 mg/dL of glucose, and trace for leukocyte. Microscopic examination
reveals presence of >100 RBCs/HPF, 8–10 WBCs/HPF, and different casts. All of these are
essential in coming up with the diagnosis as the high presence of blood, high glucose level, and
presence of different casts can indicate how well the kidneys function.
Diagnosing IgA Nephropathy is a thorough assessment of medical history, clinical
manifestations, and laboratory tests such as the urinalysis and serum immunoglobulin test,
which help strengthen the diagnosis. With that being said, overall, the researcher's interpret
this case as a case of Immunoglobulin A Nephropathy.
Orlandi, Paula F., et al. “Hematuria as a Risk Factor for Progression of Chronic Kidney Disease
and Death: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.” BMC
Nephrology, vol. 19, no. 1, 26 June 2018,
www.ncbi.nlm.nih.gov/pmc/articles/PMC6020240/, 10.1186/s12882-018-0951-0.
“IgA Nephropathy.” National Kidney Foundation, 24 Dec. 2015,

www.kidney.org/atoz/content/iganeph.
“High Creatinine Levels: Causes, Symptoms, and When to Seek Help.”

Www.medicalnewstoday.com, 27 Feb. 2021, www.medicalnewstoday.com/articles
/when-to-worry-about-creatinine-levels#:~:text=Following%20treatment%20of%20the
%20underlying. Accessed 25 Apr. 2022.

Dappmc - Araral, Maxine - PX Data & Case Def

Uploaded by

Copyright:

Available Formats

Dappmc - Araral, Maxine - PX Data & Case Def

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Dappmc - Araral, Maxine - PX Data & Case Def

Uploaded by

Copyright:

Available Formats

CHAPTER II

Patient’s Information Seriously ill 40-year-old man

Glomerular illnesses encompass a wide range of ailments with numerous causes.

“IgA Nephropathy.” National Kidney Foundation, 24 Dec. 2015,

“High Creatinine Levels: Causes, Symptoms, and When to Seek Help.”

You might also like