A 28-years-old female patient presenting for evaluation of acute kidney injury and new-onset proteinuria. She had a previous diagnosis of uveitis and arthralgia treated with methotrexate for few years and currently on hydroxychloroquine. She also had two episodes of miscarriage.
Labs: sCrea: 1.25 mg/dL (baseline: 0.9 mg/dL); albumin: 3.0 g/dL; UPCR: 1.7 g/g pf creatinine; UA: 3+ protein; 10-20 RBCs.
Serology: Low C3; Low C4; +anti-DS-DNA
A kidney biopsy is shown in figure 1.
The immunofluorescence is positive for IgG, IgA, IgM, C3, and C1q in glomeruli.
The biopsy shows:
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