Contributed by Marie C. DeFrances, MD, PhD and Sheldon Bastacky, MD
Published on line in May 1998
The patient is a 20 year old white man who presented with nephrotic syndrome and gross hematuria associated with episodes of synpharyngitis. The patient was taking no medications. Review of systems revealed flank pain. On physical exam, blood pressure was 150/90.
Creatinine - 1.3 mg%; BUN - 15 mg%; urine protein - 4.1 gm/day (4+ by dipstick); ANA negative; ASO - not performed; C3 - 107 mg/dl (normal - 75 - 140 mg/dl); C4 - 20 mg/dl (normal 4 - 36 mg/dl); C3 nephritic factor - 9% lysis (normal - <11 % lysis); urine sediment many RBCs and two RBC casts; urine culture not obtained; ultrasound kidneys bilaterally decreased in size.
ELECTRON MICROSCOPIC EXAMINATION