A 42-year-old with a past medical history of hyperlipidemia presented to the OPD with weakness, fatigue and oedema of the face and extremities. Laboratory investigations Anemia (9.8 mg/dL) Renal insufficiency (creatinine 2.3 mg/dL) A weak positive ANA of 1:80 with the nucleolar pattern, elevated rheumatoid factor, and negative hepatitis B and C serologies. Urine sediment contained a small number of erythrocytes and white blood cells and granular and hyaline casts. Because of the patient's clinical picture, including moderate anaemia, a serologic evaluation for parvovirus B19 was performed, which was positive for both IgG and IgM antibodies.
Additionally, because of renal failure, a renal biopsy was performed. Light microscopic examination of the glomeruli demonstrated mild-to-moderate mesangial and focal endocapillary proliferation. Increased numbers of neutrophils and mononuclear…
