Link to Biopsy

A 14 year-old caucasian male developed swelling and was found to have heavy proteinuria. Renal biopsy revealed apparent minimal change disease. He was treated with prednisone and had an incomplete initial response, but had clearing of edema by 5 weeks and proteinuria by 8 weeks. His prednisone was tapered in the usual manner and he did well.

ENMT: Normal

Neck: supple

Chest: symmet, cva neg

Resp: clear

CV: no m/g

ABD: distended, soft, non-tender with everted umbilicus and positive fluid wave

GU/Pelvic: moderate edema with small bilateral hydrocoeles

Lymph: wnl

Musc/Skel: wnl

Skin: marked pitting edema throughout

Neuro: alert, oriented

Psych: cooperative

SODIUM (137-145) mEq/L 135.0 L

POTASSIUM (3.5-5.1) mEq/L 4.2

CHLORIDE (98-107) mEq/L 108 H

CARBON DIOXIDE (22-30) mEq/L 26

ANION GAP (7-16) mEq/L 1.0 L

GLUCOSE, FASTING (74-106) mg/dl 79

UREA NITROGEN BL (6-20) mg/dl 9

CREATININE (0.5-1.0) mg/dl 0.8

TOTAL BILIRUBIN (0.2-1.3) mg/dl <0.1

TOTAL PROTEIN (6.0-8.0) g/dl 3.9 L

ALBUMIN (3.2-4.5) g/dl 1.3 L

CALCIUM (8.4-10.2) mg/dl 7.3 L

SGPT ALT (1-72) IU/L 24

PHOSPHORUS SERUM (2.5-4.5) mg/dl 4.7 H

URIC ACID (4.4-7.6) mg/dl 5.1

SGOT AST (1-59) IU/L 35

ALK PHOSPHATASE (29-118) IU/L 169

MAGNESIUM (1.7-2.2) mEq/L 1.4

CHOLESTEROL (0-199) mg/dl 448 H

TRIGLYCERIDE (40-160) mg/dl 1161 H

HDL CHOLESTEROL (27-75) mg/dl 18 L

WBC COUNT (4.8-10.8) TH/mm3 9.2

RBC COUNT (4.50-5.30) MIL/CUMM 5.01

HEMOGLOBIN (13.0-16.0) g/dl 15.2

HEMATOCRIT (37.0-49.0) % 43.2

MEAN CELL VOLUME (78.0-98.0) fl 86.3

MEAN CELL HGB (25.0-35.0) PG 30.3

MN CELL HGB CONC (31.0-37.0) g/dl 35.1

RED CELL DISTRIB (13.2-16.0) % 13.5

PLATELET COUNT (140-440) TH/CUMM 343

MEAN PLT VOLUME (7.4-10.4) fl 7.6

LYMPHOCYTE % (15.0-41.0) % 51.9 H

MONONUCLEAR % (0.0-11.0) % 3.8

NEUTROPHIL % (60.4-82.4) % 40.6 L

EOSINOPHIL PERCE (0.0-4.0) % 3.3

BASOPHIL PERCENT (0.0-2.0) % 0.4

LYMPHOCYTE ABSOL (0.96-3.84) 4.80 H

MONONUCLEAR ABSO (0.06-0.74) 0.30

NEUTROPHIL ABSOL (1.87-8.47) 3.70

EOSINOPHIL ABSOL (0.0-0.4) 0.3

BASOPHIL ABSOLUT (0.0-0.2) 0.0

RBC MORPHOLOGY Within normal limits

PLT ESTIMATE (ADEQUATE) Adeq

SED RATE (0-15) mm/hr Greater than 125

URINE CREAT CONC mg/dl 220

URINE PROTEIN mg/L 21140

PROTEIN/CREAT RA (0.00-0.10) mg/mg 9.97 H

CALCIUM CONC UR mg/dl 1.6

CA / CREAT RATIO (0.00-0.13) mg/mg 0.01

URINE SODIUM CONC mEq/L 238

URINE POTASSIUM mEq/L 51

CHLORIDE CONC UR mEq/L 204