A 20-year-old African American female has been experiencing a low-grade fever, loss of appetite, and joint swelling in her wrists and fingers. She visits her physician who attributes the symptoms to arthritis and provides her with anti-inflammatory medication. A month later the female returns because of a unique rash that develops across the cheeks of her face and bridge of her nose.

The physician performs a complete physical examination and orders a urinalysis. The results are as follows:

 
Physical and Chemical Results:

Color:	Straw	Protein:	3+	Blood:	Moderate
Appearance:	Cloudy	Glucose:	Negative	Urobilinogen:	Normal
Specific Gravity:	1.020	Ketones:	Negative	Nitrite:	Negative
pH:	5.0	Bilirubin:	Negative	Leukocyte:	Negative

Microscopic Results:

RBC: 20-50/hpf
Cellular Casts (Red blood cell) 0-2 /lpf
Squamous epithelial cells: 0-5/hpf

Questions:

1. Are there any correlations or discrepancies in the results?

      Answer 1

2. What disease does this patient have?  What clinical symptoms and urinalysis results led you to this answer?

            Answer 2

3. What kinds of cells are seen here? How do these relate to the patient’s diagnosis?

            

            Answer 3

4. Which part of the kidney is failing to function properly?

      Answer 4

5. What image is seen below and is it normal in a patient with SLE?

  

  Answer 5

***go to case study #2***

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