The 8-Year-Old Thai Girl from Chonburi Province Came with a Fever for 2 Weeks. She was a Red Rash on the Body 1 Day Prior to the Hospital.

Abstract

The 8-year-old Thai girl from Chonburi Province came with a fever for 2 weeks. She was a red rash on the body 1 day prior to the hospital.

Physical examination: Temperature 39 C, Blood pressure 140/89 mmHg, mild pale, generalized erythematous target lesion at face, torso, back, buttocks and extremities, others were normal

CBC: Hb 10.4 g/dL, Hct 32.5%, MCV 48.8 fL, WBC 3680 cells/cumm, N 32%, L 34%, M 2%, E 15%, band 13%, platelet 227,000/uL

C3 0.39 g/L, C4 2.5 g/L, Anti-Smith antibody negative, Direct antiglobulin test positive 3+

Anti-dsDNA 1:160, Homogenous pattern 1:1280, ANA positive

UA: pH 5.5, Sp gr 1.014, protein 3+, blood 2+, RBC 10-20 cells/HPF, WBC 2-3 cells/HPF

24-hour urine protein 2.8 gm/day

The patient underwent a renal biopsy.

The result is as shown in the picture.

Quiz

1. Please describe what is found in the histo-pathological section.

Answer:

1. Please provides the diagnostics.

Answer:

1. What is the most appropriated treatment of choice?

Answer: