A 34-year-old woman with systemic lupus erythematosus presents with acute onset hematuria and flank pain. Vital signs: BP 152/96 mmHg, HR 98/min, RR 18/min, Temp 37.2°C, SpO2 98% on room air. Serum creatinine is 2.1 mg/dL (baseline 0.8). Urinalysis reveals 3+ proteinuria, dysmorphic RBCs, and RBC casts. Serum complement levels are low; ANA is positive. Urine eosinophils are absent. Which of the following is the most likely diagnosis?
- A)Acute tubular necrosis from drug toxicity
- B)Acute interstitial nephritis from NSAID use
- C)Prerenal azotemia from volume depletion
- D)Thrombotic microangiopathy from SLE-associated antiphospholipid syndrome
- E)Lupus nephritis with acute proliferative glomerulonephritisGABARITO
Explicação
Lupus nephritis is a manifestation of systemic lupus erythematosus and presents with active urinary sediment (dysmorphic RBCs and RBC casts), proteinuria, hematuria, low complement levels, and declining renal function. RBC casts are pathognomonic for glomerulo... Ver explicação completa e trilha adaptativa →