A 32 year old man presents with progressive leg swelling and frothy urine for 2 months. He has a history of HIV infection and intermittent heroin use. Examination shows bilateral pitting edema. Urinalysis reveals 4+ protein and oval fat bodies. Serum albumin is decreased. Renal biopsy shows sclerosis and hyalinosis involving segments of some glomeruli. Which of the following is the most likely diagnosis?
- A)Diabetic nephropathy
- B)Focal segmental glomerulosclerosisGABARITO
- C)Minimal change disease
- D)Membranous nephropathy
- E)Amyloidosis
Explicação
Focal segmental glomerulosclerosis is correct. The nephrotic syndrome, HIV infection, and heroin exposure point strongly to FSGS, which shows segmental sclerosis of some glomeruli and often progresses to chronic kidney disease. Loss of podocyte integrity incre... Ver explicação completa e trilha adaptativa →