01-02-2010, 06:52 AM
A 21-year-old woman is evaluated for facial and lower-extremity edema of 1 week's duration. For the past 3 weeks, she has had fatigue. She has no history of diabetes mellitus, cigarette smoking, or illicit drug use.
On physical examination, blood pressure is 90/55 mm Hg. Cardiac and pulmonary examinations are normal. There is periorbital edema. The abdomen is soft and without masses. There is 2+ lower-extremity edema.
Laboratory Studies
Creatinine: 0.7 mg/dL (61.89 μmol/L)
Total cholesterol: 325 mg/dL (8.4 mmol/L )
Albumin: 2.9 g/dL (29 g/L)
C3 and C4:Normal
Urinalysis
Specific gravity 1.026, 3+ protein, 0“1 erythrocytes/hpf, numerous oval fat bodies/hpf
24-Hour urinary protein excretion: 15 g/24 h
Which of the following is the most likely diagnosis?
A Minimal change glomerulopathy
B Membranous nephropathy
C Focal segmental glomerulosclerosis
D Membranoproliferative glomerulonephritis
E Systemic lupus erythematosus nephritis
On physical examination, blood pressure is 90/55 mm Hg. Cardiac and pulmonary examinations are normal. There is periorbital edema. The abdomen is soft and without masses. There is 2+ lower-extremity edema.
Laboratory Studies
Creatinine: 0.7 mg/dL (61.89 μmol/L)
Total cholesterol: 325 mg/dL (8.4 mmol/L )
Albumin: 2.9 g/dL (29 g/L)
C3 and C4:Normal
Urinalysis
Specific gravity 1.026, 3+ protein, 0“1 erythrocytes/hpf, numerous oval fat bodies/hpf
24-Hour urinary protein excretion: 15 g/24 h
Which of the following is the most likely diagnosis?
A Minimal change glomerulopathy
B Membranous nephropathy
C Focal segmental glomerulosclerosis
D Membranoproliferative glomerulonephritis
E Systemic lupus erythematosus nephritis