Background
Case scenarios
Case 1
▪ | Urea: 4.9 mmol/L |
▪ | Creatinine: 52 umol/L |
▪ | Haemoglobin: 152 g/L |
▪ | HbA1c: 35 mmol/mol |
▪ | Serum total protein: 69 g/L |
▪ | Albumin: 41 g/L |
▪ | Urine microalbumin: 239.1 mg/L |
▪ | 24-hours urine protein: 0.32 g/24 hours (0.10 g/L) from left kidney and 0.46 g/24 hours (0.19 g/L) from right kidney. |
▪ | Urine electrophoresis: No monoclonal bands were detected. |
▪ | Serum Glomerular Basement Membrane antibody screen: Negative |
▪ | Serum Neutrophil Cytoplasmic Antibody screen by florescence: Positive p-ANCA not MPO. The significance of this antibody is unknown. |
▪ | Serum Anti-Proteinase (c-ANCA): Negative |
▪ | Serum Anti-Myeloperoxidase (p-ANCA): Negative |
Case 2
▪ | Serum Total Protein: 77 g/L; Albumin: 41 g/L. |
▪ | Serum protein electrophoresis: No abnormal bands detected. |
▪ | Serum immunoglobulins: |
▪ | Serum Immunoglobulin G: 18.09 g/L (reference range: 6.0-16.0) |
▪ | Serum Immunoglobulin A: 4.14 g/L (reference range: 0.8 – 2.8) |
▪ | Serum Immunoglobulin M: 2.08 g/L (reference range: 0.5 – 1.9). Polyclonal increase of immunoglobulins was associated with infection, liver disease, or various connective tissue diseases. |
▪ | Serum Connective Tissue Diseases screen: Negative (tested for U1RNP, SS-ARo (60 kDa, 52 kDa), SS-B/La, Centromere B, Scl-70, Jo-1, Fibrillarin, RNA Pol III, Rib-P, PM-Scl, and PCNA, Mi-2 proteins and Sm proteins and dsDNA). |
▪ | Serum Glomerular Basement Membrane Screen: Negative. GBM Quantification: less than 0.8 Elisa units (0–6.9). |
▪ | Serum Neutrophil Cytoplasmic Antibody Screen by fluorescence: Negative. |
▪ | Serum Anti-Proteinase 3 (c-ANCA): Negative 0.2 IU/ml (0–1.9). |
▪ | Serum Anti-Myeloperoxidase (p-ANCA): Negative (less than 0.2 (0–3.4). |
Case 3
▪ | Urea: 5.3 mmol/L. |
▪ | Creatinine: 121 umol/L. |
▪ | Haemoglobin: 117 g/L. |
▪ | July 2013: Urine protein: 1.43 g/L |
▪ | Protein:creatinine ratio: 201.4 mg/mmol. |
▪ | October 2013: Urine protein: 1.51 g/L. |
▪ | December 2013: Urine protein: 1.57 g/L. |
▪ | Urine protein from left nephrostomy: 0.52 g/24 hours; |
▪ | Urine protein from right nephrostomy: 0.53 g/24 hours. |
▪ | Serum total protein: 61 g/L; Albumin: 32 g/l. |
▪ | Serum IgG: 13.29 g/L (reference range: 6.00-16.00). |
▪ | Serum IgA: 2.85 g/L (reference range: 0.80-4.00). |
▪ | Serum IgM: 0.72 g/L (reference range: 0.50-2.00). |
▪ | Serum protein electrophoresis: No abnormal bands were detected. |
▪ | Serum Glomerular Basement Membrane Screen: Negative. |
▪ | Serum Neutrophil Cytoplasmic Antibodies Screen by fluorescence: Negative. |