Hello sir, Patient’s name is ********. Her Histopathological report: Renal biopsy (5slides for opinion) shows 21 glomeruli, 16 show near global glomerulosclerosis. Remaining shows mild increase in mesangial cellularity, capillary wall thickening with double contouring, endothelial swelling, narrowing and occlusion of capillary lumina(acellular glomeruli). There is segmental fibrin disposition and three fibrocellular crescents are also noted. There is modular tubular atrophy. Histological features favour thrombotic microangiopathy with 70-80% chronicity in all renal compartments. Doctors have suggested Plasma therapy now. The patient had dialysis 5-6 times. Today first session of plasma was administered. It is to be given for 15 days daily to replace the plasma. (Maybe, technically, I am wrong about just the plasma thing) I will be extremely grateful if you could advise the expected course of treatment. I will be online after 23 Hrs. I am from India.

I am unable to make medical recommendations, treatment recommendations or offer a prognosis without performing a complete history and physical examination.  The kidney biopsy suggest that the patient could have Hemolytic Uremic Syndrome (HUS), Thombotic Thrombocytopenic Purpura (TTP), malignant hypertension, scleroderma, post partum kidney failure, or atypical HUS.  All of these diseases are a possibility.  The kidney biopsy suggests significant destruction of the kidney.  I recommend that you discuss your concerns with the physicians who are caring for this person.

 

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