A 65 year old female patient known to have SLE (positive ANA; articular involvement; ITP and alopecia) present for new-onset nephrotic syndrome. Two weeks ago, the patient had a total knee replacement surgery complicated by a deep vein thrombosis requiring 6 months of anticoagulation therapy. For the SLE, she was treated intermittently with hydroxychloroquine with good response. She presented for a new-onset nephrotic syndrome without acute renal injury. The physical exam showed a normal blood pressure and severe lower extremity edema.
Labs:UA: prot 3+; blood negative; RBC 1-2; WBC 1-2UPCR 7.3 g/g of creatinine.Complement level are normal; ANA and anti-DS-DNA is negative
Which option is NOT an appropriate next step?
After 6 months of MMF therapy, the patient is still nephrotic. The kidney biopsy shows normal light microscopy. The CORRECT statement regarding the histology is:
What is the long term prognosis of this patient?
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