A 30-year-old man presents with generalized edema and hypeension. Urine examination shows subnephrotic proteinuria (< 2gm) and microscopic hematuria. Serum complement levels are decreased and he is positive for anti-hepatitis C antibodies. The most likely diagnosis is:
Answer is C >B (Membranoproliferative Glomerulonephritis > Cryoglobulinemia): The association of generalized edema, hypeension, proteinuria, hematuria along with hypocomplimentemia and positive anti-hepatitis C antibodies may be seen in both Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia. With the limited information provided in question MPGN appears to be a better option in comparison to Essential Mixed Cryoglobulinemia for the following reasons: Cryoglobulinemic Glomerulopathy is most common with the Mixed Cryoglobuliinemias Type II and III that are most common in females and begin in the sixth decade. The patient in question is a male in the 4rn decade of life (30years) Most patients with cryoglobulinemia present with variable combination of stress ulceration, ahralgia, fatigue and Raynaud's phenomenon other than renal manifestations. The fundamental finding is presence of circulating cryoprecipitates. The patient in question is not presenting with any of the above features to our Mixed Cryoglobulinemia over MPGN. Membranoproliferative glomerulonephritis is responsible for 80% of all Renal lesions in Essential Mixed Cryoglobunemia.
Post streptococcal Glomerulonephritis (PSGN)
Cryoglobulinemia
Membranoproliferative Glomerulonephritis (MPGN)
c abd b