Case Report

The Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA), Associated with Renal Compromise and Cutaneous Calcinosis: A Case Report and Literature Review

Table 1

Laboratory test.

UrinalysispH: 6
Specific gravity: 1.020
Sediment: RBCs 0, WBCs 15–20/HPF, leukocyte casts 6–8/HPF, abundant bacteria
Blood urea nitrogen43 mg/dL (5–20) (estimated GFR by CKD-EPI: 17 ml/min/1.73 m2)
Creatinine3.1 mg/dL (0.7–1.3)
Chloride107.1 mmol/L (95–106)
Sodium135.5 mmol/L (135–145)
Potassium4.4 mmol/L (3.5–5.0)
Serum calcium12.6 mg/dL (8.5–10.0)
Phosphorus4.5 mmol/L (1.2–1.45)
Hemogram(i) Hb: 10.4 g/dL (12–15)
(ii) Hematocrit: 33% (35–45%)
(iii) Mean corpuscular volume (VCM): 87 (80–100)
(iv) White blood cells: 15,200 (4,500−10,000)
(v) Neutrophils: 9,790
(vi) Lymphocytes: 4,330
(vii) Platelets: 249,000 (150,000–450,000/mm3)
Albumin4.1 g/dL (3.5–5.5)
24-hour urine protein1.934 mg/day (<150 mg/day)
Glucose91.6 mg/dL (70–100)
C-reactive protein<0.5 mg/dL (<0.5)
ALT (alanine aminotransferase)30 U/L (7–50)
AST (aspartate aminotransferase)66.7 U/L (5–40)
BilirubinTotal 0.2 mg/dl, indirect 0.2 mg/dL
ANA (antinuclear antibody)Positive, speckled pattern, 1 : 160
ANCAs by IFINegative
Anti-double-stranded DNA antibodiesNegative
Anti-La antibodies2.40 (negative)
Anti-Ro antibodies10.30 (negative)
Anti-SM antibodies3.50 (negative)
Anti-RNP antibodies1.10 (negative)
Complement C424.5 (consumed)
Vitamin D 25-hydroxy17.2 ng/mL (20–40)
Vitamin 1,25 dihydroxyvitamin D12.5 pg/mL (18–78)
PTH (parathyroid hormone)5.12 pg/mL (15–65)
PTHrP (parathyroid hormone-related protein)12.4 pmol/L (0.0–2.0)
Cortisol (8 am morning)267 nmol/L (140–690)
TSH (thyroid stimulating hormone)2.09 mUI/L (0.3–4.7)
Serum protein immunoelectrophoresisNo detectable monoclonal component
PPD (purified protein derivative)Negative
HIVNegative
Hepatitis B and C virusesNegative