2. A 25-year-female patient named Nora farouk , from
Mansoura ,house wife , married with 2 off springs .
No special habits.of medical importance
Personal history
4. Present History
The condition started since one month by
gradual onset progressive course of massive
oedma L.L and puffiness of both eye lids.
5. Past Hx (cont.)
Past Hx of one abortion.with no past Hx of DVT.
No past Hx of DM or HTN or NSAIDS abuse
No past Hx of similar disorder.
.
6. Past Hx of anemia since 2 months managed by
anemia work up that revealed normocytic
normochromic anemia with marked
anisopoikilocytosis &pencil cells with normal
white cells and platelets .
Bone marrow biopsy show active bone marrow .
Past Hx (cont.)
7. Patient recived 2 units of blood and steroid 20 mg
daily and azathioprine at hematology department .
The patient stopped ttt from her self after one
month to avoid side effects of steroids.
Past Hx
8. From that while patient develop anemia and
oedma started to appear.
Past Hx (cont.)
9. No family Hx of similar disorder .
Family Hx of HTN (father and mother).
Family Hx
11. C3 & C4 normal
Direct coombs test : weak positive.
S.Albumin 1.8 mg/dl.
S. Calcium 7.5 mg /dl.
Antiphospholipd –ve .
Lab(cont.)
12. Pus 6-8
RBCS 7-10
PTN +++
Few granular cast.
Alb/Creat. Ratio 7892 mg/g
(n. less than 30)
Urine analysis
13. Average size both kidneys.
Normal echogenicity.
No back pressure .
No stones .
Normal sonographic finding of other abd. Organs.
Abd U/S
14. BL/ P 130/ 90
Temp 37 c
Pulse 85 b/min
Average body built .
Massive oedma of both LL extend to anterior abd.
wall.
No skin rash ,artheritis ,oral ulcers or alopecia .
Other examination un remarkable
Clinical Examination
