ANCA - Associated Vasculitis Case Study


Patient Story:
  • 70 years old male
  • Upon seeing the GP (On 01.05.20), the patient presented with persistent cough,  rash, and shortness of breath, and feeling unwell.
  • Previous medical history: asthma, nose bleeds, recurrent, nasal congestion, fatigue and rash since October 2019. 
  • Patient was referred to a respiratory consultant (as an outpatient) on the 14.05.20
  • The patient was admitted to K hospital, with collapsed lung.
  • Then transferred to another hospital as an inpatient on 21.05.20 with rapidly progressive pulmonary renal syndrome.
  • On the 23.05.20 the patient began haemodialysis, given 3 pulses of IV methylprednisolone soon after and started on cyclophosphamide on 27.05.20.

GP Results:

 Urea (2.5-7.0 mmol/L)  Creatinine (60-106 umol/L)  EGFR (>60 mL/min/1.73m2)  CRP (0-10 mg/L) 
10.12.18: 5.4 67 >60 
01.05.20 7.1111  58 160
14.05.20 19.5 301 17 161
21.05.20 30.4 508 8 121

Immunology Results (on sample from 14.05.20): 
  • IgE <2 kU/L (0-81)
  • IgE aspergillus <0.35 kUA/L
  • Aspergillus precipitins 10 mg/L (0-40)
  • ANCA: C-ANCA pattern, MPO antibody negative, PR3 antibody 50 U/mL (0-2). 
  • Anti-nuclear antibody negative 

Additional Immunology Results (on a sample from 22.05.20): 
  • IgG = 12.9 g/L (6-16). 
  • IgA = 1.5 g/L (0.2-4.0)
  • IgM = 0.5 g/L (0.5-2.0)
  • Protein electrophoresis: Low albumin, raised alpha-1 and alpha-2 globulins (with some zoning? - infection or inflammation).
  • C3 = 1.0 g/L (0.75-1.65) 
  • C4 = 0.22 g/L (0.14-0.54). 
  • GBM antibody negative

Comments

Popular posts from this blog

Passed IBMS Verification :)

Barriers To CPD By (Tahmina Hussain) - Workshop