Case presentation A 20-year-old woman presented to her GP with a 5-day history of increasing facial swelling and right loin pain. Other details noted in the referral letter include a 2 -day history of reduced urine output. Her blood pressure is elevated at 150/85 mmHg. In addition, the GP has noted that the urine produced is dark in color (the patient describes it as ‘like coke’). Urine dipstick shows protein+++ and blood ++++. Medication history A 5-day course of penicillin for severe tonsillitis.
Five days ago, she noticed that her face was a little swollen. Since then, her legs have become swollen, and her urine has darkened and looks ‘like coke.’ Physical examination Pitting edema in the knees. There are no apparent rashes. Her pharynx is not erythematous, but she does have a couple of palpable cervical lymph nodes bilaterally (1 cm in diameter). Pulse - 80 bpm BP- 155/85 mmHg JVP…
