A 62-year-old woman presented to her GP. Presentation Tiredness, lethargy, aching joints, poor appetite and nausea of 4–6 weeks’ duration. Physical examination Physical tests were unremarkable except pallor and a BP of 160/100 mmHg. Further examination revealed purpuric spots in both legs. Laboratory tests Haemoglobin (Hb) 10 g/dL Blood urea 26 mmol/L and Serum creatinine 386 μmol/L (glomerular filtration rate or GFR 14 mL/min).
Urinalysis revealed +++ blood and +++ protein What are the Differential Diagnoses? What are the further investigation needed to confirm the diagnosis? If the person is too ill to conduct a renal biopsy, which test can give a presumptive diagnosis so that immunosuppressive treatment can be started? *This case is from Docplexus Editorial Team for educative purpose only.
