Question

Urinalysis Case 6-2 Kate R., a high school basketball player, had been hosnitalized with a threat infection, fever, and a question of pneumonia. She had been taking some antibiotics. Her physician noted edema and elevated blood pressure. See Table 6-2 for UA results. Table 6-2 Urinalysis Kate R. Reference Range Macroscopic Color Appearance Specific gravity pH Protein Glucose Ketones Bilirubin Blood Urobilinogen Nitrite Leukocyte esterase Red Cloudy 1.028 6.0 2+ (100mg/dL) (SSA:2+) Neg Colorless to amber Clear 1.001-1.035 5-7 Neg Neg Neg Neg Neg Normal Neg Neg Neg Negro 2+ (50 RBCsul Normal Neg Neg Microscopic WBCS RBCS 0-5/HPF 0-2/HPF Epithelial cells Few to moderate 0-3/HPF 30-60/HPF (dysmorphic forms present) Few squamous/HPF Rare transitional/HPF 1-3 hyaline/LPF 0-3 RBC/LPF 1-3 granular/LPF Neg Casts Few-hyaline Bacteria None Additional Urinalysis Tests Kate R. Reference Range 400 ml 1200-1500 mL/24 h 1 g/24 h 50-80 mg 24h 24-h urine volume 24-h total protein Chemistry BUN Creatinine Kate R. 28 mg/dL 1.6 mg/dL Reference Range 7-24 mg/dL 0.5-1.2 mg/dL

Answer 1

1) Group A Streptococcus is the possible causative agent for strep throat. Group A Streptococcus is the most common organism responsible for streptococcal pharyngitis also called as strep throat. It is usually transmitted through droplets of saliva from the infected person. Group A Streptococcus consists of M- Protein and exotoxins. Antigen presenting cells (immune cells) of our body engulfs the bacteria and present it to T- cells and B - cells, this induces immune response - fever and inflammation are a part of immune response.

Some of our body cells contains M-Protein which look structurally similar to M-Protein of Group A Streptococcus so antibodies that are formed against M-Protein of Group A Streptococcus attacks body's own cells due to same structure(called as molecular mimcry). These antibodies also form immune complexes that attack kidneys leading to post streptococcal glomerular nephritis.

2)Other possible causes of this disease include group B streptococcus,mycoplasma pneumoniae associated glomerular nephritis, influenza virus, underlying autoimmune diseases like lupus, IgA nephopathy.

3)Yes. As Acute Postinfectious glomerulonephritis is acute damage to glomerulus of kidney leading to azotemia( raised BUN and s.creatinine).