Combination of lupus nephritis and diabetic nephropathy with rapid depression of renal function

Violina Minkova, F Rushidova, M Jordanov and R Robeva

Military Medical Academy, Bulgaria

Scientific Tracks Abstracts: J Transplant Technol Res

Abstract :

A 51 year-old woman with nephrotic syndrome since 6 months-proteinuria 8.1g/ 24 h, serum albumin 29, 25, 19.6 g/l, oedema, rapid depression of renal function-serum creatinin 159- 200-462 mmol/l; Hypertension since 2 years; Diabetes mellitus since May 2018; Anti-ds DNA-63.3; Sonography: the two kidneys are of normal size and location; echodencity- Ð? degree; Renal biopsy: 21 glomeruli, 3-obsolescent; In some of the glomeruli a moderate mesangial hypercellularity is seen. In the mesangial regions of most glomeruli hyaline nodules with cellular borders, fibrin caps and hyaline thrombi are seen. In few glomeruli there is an extracapillar proliferation with forming of crescents. Many areas of atrophic tubules and mononuclear infiltrates in the interstitium are seen as well; Blood vessels-severe hyalinosis in the walls of the small arteria and arterioles; Immunofluorescence: light segmental subendothelial IgA deposition and 2-3+ IgM, 3+ C1q and 4+C3 with the same localization. The morphological diagnosis was combination of lupus nephritis and diabetic nephropathy, causing a rapid depression of renal function. A therapy with i.v. application of Metjylprednizolon 250 mg, Endoxan 500 mg, Klexan 2x 0.4 ml and symptomatical medicine was prescribed. Serum creatinin decreased to 395 mmol/l; oedema reduced and the cough disappeared.

Biography :

Violina Minkova is the Head of Clinic of General and Clinical Pathology in Military Medical Academy in Sofia. She is a leading pathologist, specialized in the field of renal biopsy, with an extensive professional experience. She applies histological, histochemical immunohistochemical and electronmicroscopical methods in the diagnosis of immune nephropathies. In her everyday practice, she provides diagnostics for congenital and hereditary nephropathies with the use of electron microscopy and electronmicroscopical morphometry. She has contributed significantly to the development of diagnostic methods for C3- nephropathy, renal amyloidosis, the disease of thin membranes and Alport’s syndrome. She has participated in numerous symposia and has many publications in Bulgarian and international reviews. She provides expert consultations on matters of renal biopsies and gives professional training to younger physicians qualified in nephropathology. She is member of the Bulgarian society of pathology, the Bulgarian society of nephrology and ERA\EDTA.

E-mail: peterbal@mail.bg