A 22-year-old woman presents with bilateral lower limb swelling, and puffiness on her face for the past three months. A routine health examination revealed proteinuria (3+) and microscopic hematuria (1+), prompting evaluation by a local physician.
Vital parameters:
BP: 124/87 mmHg
HR: 75/min
SpO2: 98 %
Physical examination:
Mild bilaterally
Lower leg edema as well as an unremarkable abdominal examination and pulse status.
Laboratory:
Hemoglobin (12.4–16.1) g/dL: 11.2
White blood cells: (4.0–11.8) Mrd/L: 6.7
Albumin (34–50) g/L: 38
Creatinine (0.7-1.2) mg/dL: 1.72
Immunology:
C3 (90-170) mg/dL: 47
C4 (12-36) mg/dL: 10
ANA (< 1:80) Titer: 1:80
c-ANCA (< 1:20): negative
p-ANCA (< 1:20): negative
GBM-AB (< 7) U/mL: negative
Cryoglobulin (negative): negative
ASO：72IU/ml
Urine:
Urine protein-creatinine ratio (uPCR) mg/g: 2569
Urine sediment:
Some eumorphic red blood cells, few granulated cylinders, some epithelial cells.
Note related to annotations: To avoid obscuring the lesions, the annotations are deliberately positioned close to, but not directly over, the lesion areas.