- Patient timeline table.
| Dates | Relevant past medical history and interventions | ||
|---|---|---|---|
| 12th April 2021 | The patient presented with a history of abdominal pain for five days, 2 days after getting Covid vaccine(AstraZeneca). His symptoms were associated with vomiting, diarrhea and decreased oral intake. | ||
| Summaries from initial and follow-up visits | Diagnostict testing | Interventions | |
| 12th April 2021 | He was admitted for work up of renal impairment and cytopenia. | WBC 3.4 x109/L Hgb 123 g/L Plt 121 x109/L Urea 12.7 mmol/L Creat 284 micromol/L | Started on intravenous fluids for hydration. Laboratories and radiological studies were ordered |
| 13th April 2021 | Assessed by nephrology team and planned for biopsy | Abdominal CT without contrast showed small non-obstructing right renal stones, bilateral renal cortical scarring, mild splenomegaly and hiatus, and left inguinal hernias 24-hour urine protein: 6.12 g/day | |
| 21th April 2021 | Assessed by Infectious Disease team | Brucella serology was requested. The test results were positive (1:2560). | Started on doxycycline, ceftriaxone and ciprofloxacin |
| 21th April 2021 | 99mTechnetium dimercapto succinic acid scan showed a relative renal function of 28% on the right side and 70% on the left side. | ||
| 22th April 2021 | Renal biopsy showed segmental scarring. Strong staining was observed for IgM, kappa and lambda light chains, and C1q, confirming immune complex-mediated glomerulonephritis, with segmental scarring. Interstitial fibrosis tubular atrophy of 40% was observed. | ||
| 24th April 2021 | Patient was discharged with clinic follow up with Nephrology and Infectious disease clinics | ||
| 25th May 2021 | Infectious disease clinic | To complete the course of antibiotics | |
| 8th November 2021 | Nephrology clinic | Stable kidney functions | |
WBC: white blood cell, Hgb: hemoglobin, Plt: platlet, Creat: creatinine, ImG: immunoglobulin M, C1q: complement component 1q