A 25-year-old man with no known history of interest. He has been presenting with foamy and loaded urine for 2 months, with no other symptoms. Physical examination without findings. Elemental urine: pH 5; glucose negative; hemoglobin ++; protein ++; leukocyte esterase negative; proteinuria 1.5 g/24 hours; urinary Na 60 mEq/L; urinary K 30 mEq/L; urinary Cl 100 mEq/L. Blood biochemistry: creatinine 1.6 mg/dL; urea 80 mg/dL; Na 140 mEq/L; K 3.8 mEq/L. Immunological study: antiDNA negative; ANCA negative; antiMBG negative, rheumatoid factor negative; C3 20 mg/dL (normal 60-120); C4 10 mg/dL (normal 20-40). A renal biopsy is performed. Which of these diagnoses do you think is the most likely to be found in the biopsy?
We are presented with a lot of analytical data but we only have to look at two: the levels of complement fractions C3 and C4 are low. Of the options given, only membranoproliferative glomerulonephritis presents with hypocomplementemia (option 4 correct).
Membranous glomerulonephritis.
Glomerulonephritis with minimal changes.
Mesangial IgA glomerulonephritis.
Membranoproliferative glomerulonephritis.
the levels of complement fractions C3 and C4 are low. Of the options given, only membranoproliferative glomerulonephritis presents with hypocomplementemia (option 4 correct).