Solve exciting clinical cases specific to your field of interest via Docplexus’ Clinical Case Challenge . In this ‘Nephrology Case Challenge’ , join your fellow doctors to discuss and answer today’s quiz. A 69-year-old man presented with edema, tea-colored and foamy urine. He had a one-year history of hypertension.
His clinical examination revealed systolic blood pressure of 213 mmHg. Laboratory investigation Serum creatinine - 2.1 mg/dl Urinalysis - >50 RBC/hpf, >25% dysmorphic Urinary protein excretion - 1.7 g/d Fluorescence anti-nuclear antibody - 1:40 C4 - 15 mg/dl (normal) C3 - 52 mg/dl (low) Renal ultrasound - Right kidney 10.9 cm and left kidney 12.4 cm in length with no masses, renal artery stenoses, or hydronephrosis. Light, immunofluorescence (IF), and electron microscopy (EM) are shown in the cover image. The IF was positive only for C3.