🔥 Let’s discuss an interesting case . Already discussed in #ECNeph . Trying to consolidate it.
🏥 I was called in for a nephrology consult for a patient admitted under pulmonology 🫁
🩸 Microscopic hematuria ++
🧠 What do we think in a patient with hemoptysis?
🫘 The nephrologist brain in me thought it narrower. The first hit
🧪 what does the lab has to say ?
Numerous 🩸red blood cells in urine and pulmonary haemorrhage .
💡I was sure i hit the right diagnosis 🎯
📺 how can a nephrologist proceed without an Ultrasound kidney
✅Nothing significant
🫘 Now its nephrology time to crack the case .
🛏️ Patient got re admitted
💦 oliguric renal failure
✌️ What is the clinical diagnosis ?
🚨🚨 PR3 ANCA , MPO ANCA Anti GBM - Negative, C3 - Normal
🟢 I told it could still be ANCA negative Paucimmune crescentic GN with pulmonary haemorrhage
❓What next ? Seeing is believing
💊 Empirical steroids
🔫 renal biopsy report 😳😳
😨 quite unexpected
🚨 when things don’t go the way you think its not a bad idea to go back to the patient and the previous reports
🤯 Rechecking the reports
🎯🎯 We got down to the diagnosis at the end ✌️✌️
🧐🧐 but there is a problem 🚨
🌞 We went ahead with CT Angio —> the CT revelation 👌
📈Let’s see how the disease progressed 🔴🔴
🔖 what’s the status of the patient ?
🌞 what could be the reason for renal vein thrombosis ?
🔃 when in doubt get back to the patient and old reports
💡 atypical cells within the lung biopsy —> slide sent for IHC
🚨🚨 The suspected trouble maker
🥇 The final diagnosis
🧭 Approach to rapidly progressive renal failure
🩸 Never forget the vascular cause of RPRF
🚨 RPRF with normal renal biopsy
🩸 Causes and symptoms of RVT
📌 evaluation and treatment of Renal vein thrombosis
⚠️ Do we neglect renal cysts ?
📌 The CT classification of cysts and the chances of them being problematic
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