Question

A patient N., 29 years old complains of headache, decreased diuresis during the last 5 months (up to 600 ml / day). In the history - nephropathy of pregnant women. Objective examination: swelling and pallor of the face, swelling of the feet, heart rate - 72 per minute, AT-185/110 mmHg. Common blood protein - 54 g / l, albumin-44%, ESR - 24mm / h. In urine: a relative density of 1011, a protein of -3.4 g / l, L -1-2, 10-12, granular cylinders - 8-10, uric acid crystals big quantity in the field of vision.

Questions

1. Which diagnosis is most probable?

2. What additional methods of examination should be used?

3. What is the probable reason of patient condition?

Answer 1

1.pre eclampsia

One of the most serious complication affecting a pregnant woman.

The women developed a high blood pressure, protein in her urine, swelling of face and feet,and there is evidence of damage to kidney and headache. All of these pointing towards pre eclampsia.

2.tests

.Urine protein and urine protein to creatinine ratio

. BUN, serum creatinine and uric acid

. Serum alanine amino Trantransferase (ALT) and Aspartate amino transferase(AST)

. Complete blood count

. Partial thromboplastin time

. Antiphospholipid antibodies

3.preeclampsia causes

Genetic factors

Blood vessel problems

Autoimmune diseases

Here the patient is having nephropathy, which is an autoimmune disease. Pre eclampsia occur when the women is pregnant, usually at the 20th week of pregnancy.