%0 Journal Article
%T Sickle cell nephropathy with diffuse proliferative lupus nephritis: a case report
%A Kamal V Kanodia
%A Aruna V Vanikar
%A Kamal R Goplani
%A Sonia B Gupta
%A Hargovind L Trivedi
%J Diagnostic Pathology
%D 2008
%I BioMed Central
%R 10.1186/1746-1596-3-9
%X We present here a 35 years old lady with sickle cell disease who presented with edema, dyspnoea on exertion, pyuria and had raised s. creatinine of 7 mg%. Her biopsy revealed SCN with DPLN. She is on maintenance hemodialysis after 2 months of diagnosis.DPLN with SCN is a rare entity with poor prognosis, which may be overlooked and needs aggressive management.Sickle cell nephropathy (SCN) is an important cause of mortality in patients with sickle cell disease (SCD) [1]. SCN includes hematuria, papillary necrosis, urinary concentrating defect, impaired renal acidification and potassium excretion, supranormal proximal tubular function, proteinuria, and renal failure1. Incidence of renal failure in SCD ranges from 5 to 18% [2]. SCN associated with diffuse proliferative lupus nephritis (DPLN) is a rare entity. We present here a 35 year old lady with sickle cell disease (SCD) and DPLN.A 35 year old female with SCD, presented with pedal and periorbital edema, distension of abdomen, decreased urine output and dyspnoea on exertion since 1 month. On examination, she was pale, with pulse rate of 100/minute, normal temperature, and blood pressure was 160/100 mm Hg. Her abdomen was distended due to moderate ascites however there was no organomegaly/scars. Cardio-respiratory and neurological examination was unremarkable. Ultrasonography showed right kidney, 10.9 ¡Á 6.0 cm, left kidney of 11.4 ¡Á 5.8 cm, with increased echogenicity and maintained cortico-medullary differentiation. Moderate ascites was present.On investigations, urine albumin was 500 mg/24 hours, microscopy showed 30¨C40 pus cells and 3¨C5 granular casts/high power field, urine culture was sterile, serum creatinine, 7.0 mg%, serum proteins, 4.5 gm/dL; serum albumin, 1.8 gm%, serum bilirubin was 0.5 mg/dL, serum alanine amino transferase was 16 units/L, random blood sugar was 87 mg/dL, serum uric acid was 7.5 mg/dL, serum sodium was 134 meq/L and serum potassium, 5.5 meq/L and positive sickling test was noted at 24 hour
%U http://www.diagnosticpathology.org/content/3/1/9