1. U

2. Clinical History
Mr. N S-T 18 year old male presented with one to two month history of general malaise and a more recent onset of nasal congestion, red eyes joint and muscle pain. Seen by GP; Creatinine = Urgent referral.

3. Clinical History ARF Creat = 350
Active urine sediment with red cell casts
Episclerittis/uveitis
Joint pains
?RPGN
?SLE – serology pending

4. BIOPSY

7. Immunofluorescence IgG – Negative IgA – Negative IgM – Negative
C3 – Mild mesangial
C1q – Negative
Kappa – Negative
Lambda – Negative
Fibrinogen – Negative
Albumin – Mild hyaline droplet change in tubular cytoplasm

8. C3

9. Albumin

10. EM

14. Diagnosis:
Concentric and Necrotizing Glomerulonephritis of pauci-immune character