The Application of Optical Coherence Tomography Angiography in a Patient with Systemic Lupus Erythematosus.

A 15-year-old girl presented to the emergency department with a history of bilateral blurred vision for one day, with greater severity in the right eye. Fundus examinations revealed cotton wool spots, dot hemorrhage, and hard exudate. She underwent optical coherence tomography angiography (OCTA), which showed the presence of macula ischemia, decreased vascular density, mild retinal fluid, severe ischemia, some macular edema, and vascular sheathing, indicating active vasculitis in the right eye. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect many organs in the body, including the eye. Ocular involvement is one of the most well-known features. Retinal vasculitis is a rare complication of SLE that is characterized by vascular sheathing that can progress to vaso-occlusion. We report the clinical features of SLE using OCTA.

Post-Infectious Glomerulonephritis With Crescents in an Elderly Diabetic Patient: Good Prognosis.

Post-infectious glomerulonephritis (PIGN) is an injury to glomerules mediated by the immune response after infection, and it is commonly seen in children. However, the elderly with immunocompromised conditions are at higher risk of developing PIGN after a recent infection. A 74-year-old female presented to the ER with a history of severe, sharp, on and off left flank pain for two days. Initial laboratory results workup were suggestive of acute kidney injury with no obvious reason. Dialysis was required as the renal function was deteriorating. Serologic test was negative for ANA (anti-neutrophil antibodies), C-ANCA (anti-neutrophil cytoplasmic antibodies), and P-ANCA (perinuclear anti-neutrophil cytoplasmic antibodies). C3 level was low, and anti-streptolysin O titer was high. Renal biopsy was performed. With reference to the clinical and histological examination, she was diagnosed with PIGN and diabetic nephropathy. After six months, the renal function was improving gradually until hemodialysis was stopped, and the PermcathTM (Medtronic) was removed with a creatinine level of 120 µmol/L. The elderly diabetic female developed PIGN with crescents that required dialysis, and dialysis was stopped after six months with good prognosis. Since PIGN is a very rare entity, the suspicion of PIGN in the elderly with acute kidney injury should be raised after a history of upper respiratory tract or skin infection.