Presentation is loading. Please wait.

Presentation is loading. Please wait.

Case Study 31: Chronic Renal Failure Robyn Schwartz.

Similar presentations


Presentation on theme: "Case Study 31: Chronic Renal Failure Robyn Schwartz."— Presentation transcript:

1 Case Study 31: Chronic Renal Failure Robyn Schwartz

2 Case Study 31: Chronic Renal Failure Robyn Schwartz V Goodpasture syndrome +

3 Past Medical history Went to ER 3 years ago – Coughing up blood for 6 hours – Difficulty breathing – Chills – Chest pain Recently had influenza A Lab results – Elevated white blood cell count – Iron deficiency Hepatosplenomegaly – Enlarging of liver and spleen Crackles in the lung

4 Past Medical history ELISA test positive for GBM Elevated BUN Renal biopsy positive for IgG – Immunoglobin antibody Goodpasture syndrome diagnosis

5 GoodPasture syndrome Rare Attacks lungs and kidneys Autoimmune disease – Anti-glomerular basement membrane antigens (GBM) attack body Caused by immune hypersensitivity type II – When antibodies of the immune system attach to antigens on the body’s own cells – Antigens can be intrinsic or extrinsic – Causes a B cell response

6 GoodPasture syndrome Rare Attacks lungs and kidneys Autoimmune disease – Anti-glomerular basement membrane antigens (GBM) attack body Caused by immune hypersensitivity type II – When antibodies of the immune system attach to antigens on the body’s own cells – Antigens can be intrinsic or extrinsic – Causes a B cell response

7 Treatment Put on methylpredisolone – Used to treat severe allergic reactions, blood disorders – Decreases immune response – corticosteroid hormone Plasmapheresis – 4 plasma exchanges of 1 L each daily for 2 weeks – Cleans out blood After 2 weeks symptoms resolved Maintained on azathioprine – Used to prevent rejection in kidney transplants – Reduces the proliferation of immune cells – Lowers autoimmune response Also trimethoprim and sulfamethoxazole – Antibiotics – Reduce bacterial growth

8 Follow up 6 months later Urinalysis – Low grade proteinuria and hematuria Presence of protein and blood in urine – likely caused by the damage Goodpasture syndrome did to his kidneys

9 Serum creatinine levels increased over the past 3 years Very close to end-stage renal disease Creatinine clearance levels 15.5 mL/min – End stage is 15 mL/min Suggested course – Dialysis – Kidney transplant

10 Physical exam Skin – Dry and flaky – Very pale Lungs – Mild bibasilar crackles – Likely caused by fluid in lungs Extremities – Mild edema of hands and feet Neurological – Alert – CNs II-XII intact – DTRs 2+ throughout – Muscle tone 5/5 – Positive Chvostek sign When the angle of the jaw is tapped the mouth and face will twitch Often associated with overactive sodium channels

11 Lab results

12 Lab Results

13 Lab results


Download ppt "Case Study 31: Chronic Renal Failure Robyn Schwartz."

Similar presentations


Ads by Google